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PERMITTEE NAME/ADDRESS (Include Facilip~Name/LOCation ifD~erenf) <br />NAME <br />SLUE Mf7UNTAIN ENERGY, INC <br />ADDRESSj1ESERAD;7 MINE <br />::607 CiRJNTY ROAD n,3 <br />FACILITY F'ANGLY C:U 8164EI <br />LOCATION <br />ATTIJ .1F~F T1l1RRrRT <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOES) <br />DISCHARGE MONITORING REPORT (OMR) <br />- ,-~ <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM CU 07 OI TO OG Q9 30 <br />Form Approved. <br />OMB No. 2040-0004 <br />M I N!DR <br />(SUL;R I\b! <br />F -- FINAL. <br />ACU~'E WCf TESTING FUR 0104 <br />r~BLAra <br />oath I•dU DfSCHARGE I~I ~++~ <br />NOTE: Read Instructions before completing this form. <br /> QUANTITY OR LOADING QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER EX of TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS <br />CS(' STATkC 4BHR ACU SAMPLE traR#,~# ##a~rt# ~rF~+utc --a„aa ( 23) <br />(-~Ff'iU:?AY HtIIA MEASUREMENT <br />TF:~~:.`Fi 1 0 O PERMIT ~1FiF161Y4Fi~.. 9P~f91iP~ii'„- #it ~'. ,.. %iF1G~F1F1i ###### P .-R- ~K AB <br />F~": ~.!_-:i~1T GFtO55 'JALUE REQUIREMENT ~ ,~"' p.p.a.~. .~Ay~;~ ~ <br />~ :F_NT <br />_(-`!1 ~;TeaTRE 96HR ACU SAMPLE ~tt++### ###### ###### s'arar,r:. ( 23i <br />P il`i ti'iiALES MEASUREMENT <br />pr',r i C O .- PERMI~''s .".{3'1Fi+11 ,: It#~ F c :.;.:~ <br />.~ ., <br />~ <br />gkib~l =~, <br />###### P <br />~R- <br />Y <br />FRA <br /> <br />I F' t!':_rJT 9RDSS VALUE REQUIREMENT <br />.'y <br />*#* <br />'~~ /i1.0E <br />ENT ~. `-= <br /> SAMPLE <br /> MEASUREMENT <br /> 15E'~IfvilT- e91; _ - ~' <br /> REptJIREM~NT <br /> SAMPLE <br /> MEASUREMENT <br /> Per+Mir <br />~ <br /> Fii;tSUIREMEfSf . <br />--. - - - '°: - <br /> SAMPLE <br /> MEASUREMENT <br /> ' .PERMIT. , <br />_ ~ <br /> <br />RE:OUIREMENT <br />- <br />- - <br />- * <br />,( . <br />~~ <br /> SAMPLE ~'~ <br /> MEASUREMENT <br /> <br /> REOUIREMENT ~ `' ' ~ ~ - - <br /> SAMPLE <br /> MEASUREMENT <br /> J?E~Mft .. . - - .. . <br /> REQUIREMENT '~ <br />NAME?ITLE PRINCIPAL EXECUTIVE OFFICER IGrtiry under penalty of law that lho tlocumant antl all attachments were TELEPHONE DATE <br />~_ ~ <br />~ ~~ <br />! ~ <br />' preparetl untler my direction or supervision ~n acwrtlance with a system tleslgnetl <br />to assure that <br />ualifi <br />d <br />nn <br />l <br />r <br />rl <br />th <br />r <br />tl <br />l <br />t <br />th <br />I <br />l <br />ti <br />~ <br />~ ~ ~ <br />~r <br />t. <br />Gl~ q <br />perso <br />p <br />e <br />e <br />ope <br />y ga <br />e <br />an <br />eva <br />ua <br />e <br />e <br />n <br />onna <br />on -~ <br /> submitted. 9azetl on my inquiry of the person or persons who marege the system, <br />r or those parsons tliractly responsible br gathering the IMOrmelion, ilia ~nlormatian <br />:` /1 /, G~< submittetl is, to the best of my knowletlge end beliel, true, accurate, antl complete. SIGNATURE OF PRINCIPAL EXECUTIVE ~ Ali ~~~5 f 3Z2 cam. i ~~ ~~ <br /> <br />TYPED OR PRINTED 1 em aware that there era signifiranl penaltin for submitting lalse inbrmation, <br />innudi Ilia sidli of fns antl im risonmem for knowin violations. <br />OFFICER OR AUTHORIZED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br />GUMMENTS AND EXPLANATION OF ANY VIOLATIONS (Rererence a/I attachments hem) <br />SFE PF-RT I. B. 3. PG VIII. FOR DETAILS Or TEST F'RDCEDURE REPORT LCS~: - STATI51 ~ ;-i -'I~'l~f r~f;TI19A' L^~ Ti:Fi <br />IS LETHAL TD 50% OF TEST ORGANISMS ANC ATTACH ACUTE TDX~ICITY TEST REPORT FUP,P~-~:~~~...,,„. ~:UPIFS '"- - <br />EP arm 0- 3 Previous e 1 Ions m y be used. THIS IS A 4-PART FORM PAGE OF <br />On:,'. ,~ .., .. <br />