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PERMITTEE NAME/ADDRESS (Include Facrliry•NamelGocanon ifDifferenr) <br />NAME <br />BLU}. MOUNTAIN ENERGY. INC <br />ADDRESS:,j4SERNDO MINE <br />:3F07 C^,UN'• Y R9AD h5 <br />FACILITY V~~N~L~i Cp b164& <br />LOCATION <br />A'TT JFFF LURBERI <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOESJ <br />DISCHARGE MONITORING REPORT (DMR) <br />r nnn~rgn~~ n t <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM 00 04 O1 TO ~i~J OS v<J <br />Form Approved. <br />OMB No. 2040-0004 <br />M i NCIk <br />(S13L'R NW? <br />Dr' - 7. ::ij"Li? POND l0 S',i~ ~-. iOh! Gl;l_ <br />C## Pil.t iI±SC!-iARGL~. + ! am# <br />NOTE: Read Instructions before completing this Corm. <br /> QUANTITY OR LOADING QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMET <br />R EX of TYPE <br />E AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALrsIs <br />It r~; ~~? GR;.ASE SAMPLE ##ii##t. ( yo J #;F###it iF#is -z+td I. :~.'#*# <br />j~:;~~,( MEASUREMENT C' ( <br />J /7 V <br />' <br />- - , <br />,,,. <br />q':'~~ j ~' 0 PEgNItT #iFiP~1FaF' _ •, V <br />~ .S=L •ikal~-~e+t ##iF*.## ##a+riF~t. ## EKE.Y 28llAL <br />rF' 'JL-"'•."( b'F:OSS 4AL'!E REQUIREMEN7 $`)' Mpg <br />.~~ 0=0 '" tt~# <br /> SAMPLE <br /> MEASUREMENT ._ <br /> I • <br />~ ' ~~ { _ ;- ~ .- :~w. <br /> REQUIRE <br />M~NT " <br /> SAMPLE <br />_ MEASUREMENT <br /> ~ • " <br /> pY:OUIRC-MINT .- - "S' -~, - n-~3:: ~ ^r <br />.• - <br /> SAMPLE <br /> MEASUREMENT <br /> <br />" REQUIREMENT " - - "ati """" <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> REQUIREMENT '-x' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT- ~~ r~.~ r a: " a ~" - ';fie: <br /> REQUIREMENT - " ' a; -•""' ~ " <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> REQUIREMENT - - ~ ~ " <br />NAMElTITLE PRINCIPAL EXECUTIVE OFFICER ICedily untler penalry of law Nat mis document antl ell ettammenb were <br />aretl untler m <br />tliraction or su <br />ervision in accortlance wim a s <br />netl <br />m <br />tem tl TELEPHONE DATE <br /> p <br />p <br />y <br />p <br />ys <br />es~g <br />- .-J~r ~ <br />~ ~ ~ '~ ~ ~-'r r to assure mat quallfed personnel properly gazhar end evaluate the inlorma4on <br />submittetl. eased an my Inquiry W the parson or Persona who manage the system, - ~ T-r <br />~~r- ~ f <br />~~ ' <br /> or those persons tlireclly responsible 1w Bamering the inlonnatian <br />the Information • <br />_ <br />` - , <br />aubmmetl is, to the best of my knowledge antl belief, true. accurate, end complete. SIGNATURE OF PRINCIPAL EXECUTIVE ! ~ Y '-: i.' /. - <br />/ <br /> <br />TYPED OR PRINTED I am aware mat there era significant penalties br submitting false Information, <br />inclutlin the sslbili of line and im risonmant br knows violations. OFFICER OR AUTHORIZED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />"i TG:~=~L. iROTd LiMI~TS 4JILL 3E ;JAiI'E.D, AP1U L;ET-1Lj:A5LE $LILIDFJ LlhlI1 l1FF'Lt'tii 1=%iF -,~."il' ~.i-1L ~~' ~ <br />lil-C 11 t"iN~ <br />1=~FE I. A ~_. FG V, FOR RE(3V lREMEN'TS (7iL. t:. GREASE REPDRTINrd-SEE I 3 1 F, PG ViI 3F~.TF.1_'r .P~'; F'.I Ni: <br />EP orm' 0.1 (R ^ 399) Previous a itions may be used. THIS IS A 4-PART FORM PAGE OF <br /> <br /> <br />