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PERMITTEE NAME/ADORESS sna.4.F•"reurn ssann waainuio mfmuu.soi.unNemiummaaaammaomsysratiaNNN Feral Approved. <br /> NAME Gold Basin Minc,LLC DISCHARGE MONITORING REPORT 1» ) DMB No.20400004 <br /> Approval expires 03.314E <br /> ADDREgs 17000 Wadsworth Road Mini))Ail 1flL W <br /> ITINTRI <br /> Old Mill Creek, Illinois 60083 T.^1 !rTI <br /> ATTN: Laurens Leffingweli MONIToRINGPERIOD if No FACILITY Gold Basin Mine 4 f ■._•f8UZ 1,i.v it'L•1Il�L\7 <br /> LOCATION26020 CR 298, Granite, co 81228 FROM F�1,14111)1t41 TO PI•FIR[4I:JNkIe7 NOTE: Read butructionsSeorecxempletirpMNform <br /> `x/ (20-21)(22,33)(24-25) (25.27)(2�)(�1) <br /> {J Card dry) QU41N1'ITY$4 LOADING (4 Card 445) OUA1.1TV OR EANCE►tTRATtON pp IBlty mune <br /> PARAMETER (4S 57) (5431) (7415) (4647) (34 41) ANALYSIS <br /> TYRE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 11 ) (14.04) (5470) <br /> total Copper SANFtEMEASUREMENT ug <.0004 mg/1 1 grab <br /> ANT .0056 1 <br /> Total Iron SAMFT.E <br /> meAsunemENr ug .043 mg/1 1 grab <br /> PERMIT 1 1 <br /> REQ <br /> Total Lead SAMPLEMEASUREMENT ug <001 mg/1 1 grab <br /> PERMIT .023 1 <br /> REQUMIM MINT <br /> Total Mercury wEAMAE►IENT ug <00001 mg/1 1 grab <br /> PERMIT .0014 1 <br /> REQ(.SREMENT <br /> Total Nickel SAASPUIMEASUREMENT ug <.004 mg/1 1 grab <br /> PERMIT .02 1 <br /> REQIMREMENT <br /> Total Selenium Simm1meAsoldmeg ug <0.0008 mg/1 1 grab <br /> PERMIT .005 1 <br /> REQLENT <br /> Total Silver SAMPLEMEASUREMENT ug Adipe002 mg/1 1 grab <br /> PERMIT 004 1 grab <br /> REQUIREMENT <br /> NmAYNLEPRI4CWA).EXECUTNEOPFICER «etieMVO,uwTHAT naai�� �wn®Znwwrs ` / TELEPI NE DATE <br /> GEORGE ROBINSON „" r au rex 12, wee �a+.ne 41 <br /> rOTAREN E �roahrF4� fir.., a...i ./i.._.. <br /> uw.w ra, TY rrRIBONMrae rua .r...• �6eYe ExlCtntvE �303 832.76642017 9 07 <br /> INCLUDING Tit ro4saam NO erxr�waMr VIOLA . ` <br /> TYPED OR PRINTED OPF CER OR Atrr AGSNT - NUNIER YEAR MO DAY <br /> COMMENTS AND EXPLANATION OF ANY VIOLATIONS(Reference an stfedrnents hers) <br /> EPA Form 33204(1046) (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) PAGE OF <br />