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PARAMETER <br />(3Z-f 7) <br />(3 Card Only) QUANTITY OR LOADING <br />(46.13) (3461) <br />(4 Cord Only) QUALITY OR GONC EN TR AT ION <br />IJd-4J) (46-13) 11.161 <br />N. <br />E <br />[h -A I) <br />FR E ° or "C` <br />A.ALYSI <br />IAJ -0.4, <br />SAN <br />TV <br />ov. <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS <br />Dis. Hg <br />SAMPLE <br />MEASUREMENT <br />/"1 <br />-. Y�ii'''' <br />.. <br />mg, Ji <br />' /30 <br />Gr <br />PERMfT <br />REQUIREMENT <br />0.00006 <br />0.00012 <br />Gr <br />Salinity <br />SAMPLE <br />MEASUREMENT <br />ZS <br />2-4 <br />,,, ,t, <br />mhos / / cn <br />1/90 <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />M <br />l <br />PERMIT <br />REQUI REMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />RffiQUIOt104Stet <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />1 CERT FY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY ExAMINED <br />AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN, AND RASED <br />ON MY INQUIRY OF THOSE INDIVIDUALS IMMEIAATELY RESPOHSISLE FOR <br />OBTAINING THE INFORMATION I BELIEVE THE SUBMITTED INFORMATION <br />IS TRUE ACCURATE AND COMPLETE i AM AWARE THAT THERE ARE SIG <br />NIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION INCLUDING <br />THE POSSIBILITY OF FINE AND IMPRISONMENT SEE 18 USC I IOQI AND <br />33 use lisle IPenatlers under MN, swore* n,ay +nrJude (Ines up lo JJU,#lt, <br />and ur masortwt Imprisonment of NtuTen 6lnonths and.i )rora,r <br />TELEPHONE <br />DATE <br />— <br />Robert A. Larson Consultant <br />303 <br />t./ <br />325—Tt7 <br />1 <br />� <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />OFFICER OR A U7HOR12ED AGENT <br />TYPED OR PRINTED <br />AREA <br />COUE <br />NUMBER <br />SEAR <br />MO 1 <br />/ .1I 14n ,4.Lnf JI rotorl t) 417“,11) <br />WAHa: Toro de Plata, Inc. <br />ADDRESS PA__ BOX 85_ <br />__ __ __ 0 i _ c0 81422 <br />LwItyr Revenue— Virgjnius dine <br />LOCATION SW Ouray_,, CO <br />0 MMENT AND EXPLANATION OF ANY VIOLATIONS Ildrjrrrnrr ull utnR Inlrror here <br />FROM <br />DISCHARGE MONITORING REPOI(I tL'NH) <br />i2461 '17 191 <br />CO- 0040559 <br />PERMIT NUMBER <br />YEAR MO <br />8j 7 <br />tlo 211 ell 34 <br />MONITORING PERIOD <br />PAY <br />I <br />124 1 <br />401A <br />DISCHARGE NuMRER <br />VEAP MO I DAY <br />82— ? 3 / <br />f2i Ill ON 1 (IA Ill <br />U!I'h Ifs <br />NOTE: Read instructions before completing this Corm. <br />