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. PERMITTEE NAME/ADDRESS (/nclude Faoilirv NumdLocanon r/Di$erenq
<br />NAME CYprtUg TAP.PA VALLEY COAL CORP.
<br />ADDRESS'!I8E`i le LS.j ~OUTn, F, °C Kl'~n.ti PK-
<br />41v0 cA~T aIi.rnFL CI~CLf.
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<br />FACILITY
<br />LOCATION
<br />A'"T •~. lU'•nIS d• t:_GL::^Y, (~~RF;RuL AT4Y
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM /NPOES)
<br />DISCHARGE MONITORING REPORT (DMR;
<br />f2-161 pJ- 9J
<br />CODU27154 001 .1
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAV
<br />FAOM ~~ v v ~~ v i TO v v u tl ~ ~~
<br />(2021) (22.231 (2s~25/ f2B-2)1 f2B-2W (30.3n
<br />Form Approved.
<br />~ ~ V J li OMB No. 2040-0004
<br />Approval expires OS-31-98
<br />(SU9r. NVr)
<br />.tCr'!3`. PC'J^, A T. f, cCJ' c1. CnEEK
<br />NOTE: Read Instructions before completing this form.
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF TAW THAT I HAVE PERSONALLY E%AMINED AND
<br />AND BASED ON MY
<br />AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN TELEPHONE DATE
<br /> , ~
<br />Richard Mllls INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING
<br />THE INFORMATION, I BELIEVE THE SUBMRTED INFORMATION I$ TRUE,
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<br />Environmental Manager ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT
<br />NC
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<br />/ 970-B7O-271
<br /> G F MATION I
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<br />NG THE OG ICI ~~
<br /> SIGNATURE OF PRINCIPAL EXECUTIVE
<br />TYPED OR PRINTED OFFICER OR AUTHORIZED AGENT D NUMBER YEAR MO DAY
<br />1:,
<br />•~COMMENTS AND EXPLANATION OF At
<br />ALTt-'IIN:+T'. LI`7IT5 Fort
<br />PENALTIES FOR SUBMITTIN ALSE INFOR
<br />POSSIBILITY OF FINE AND IMPRISONMEM. BEE 1B U.S.C. 51001 AND 33 U.S.C.
<br />4 1319. (Penalties under Inese statutes may include Imes up ro 510,000 entl or
<br />mevmum Imprisonment o/ between 6 months entl5 years.)
<br />!Y VIOLATIONS (Reference all attachments here)
<br />T55 L ~ETTLt'ArsL° SOLIDS (LOC rU') A?PLY
<br />PG 1H, POf± NU'iP£9 GF ?FO!-iF ?ECz!'rIRF.7!E7iT5.
<br />C$LY !F' C= 10-YLi, 24-tIP t";cCIP ? Vf ST 15
<br />CIL E CREA~F'--_ ^:F cr; r•~~ c/r (•L, 1~
<br />EPA Form 33267 (OS-95) Previous editions may not be used. (REPLACES EPA FORM Tfi0 WHICH MAY NOT BE USED.) Q 0 U 11 / U J U 4 U`~ -1 '~ O 1 PAGE 1 OF
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