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PERMITTEE NAME/ADDRESS (include Faellle~Nane/lncarion ifDiBerem)
<br />NAME CYPRUS YAMPl1 Y4LLF:Y COAL COP.-.
<br />ADDRESS!!INtiS if?:1 S7l7THf v^XRAN n4
<br />910(1 FAST ^IM~'RAL ^Ir!CLF.
<br />°.kcLE.~7n CO RO155
<br />FACILITY
<br />LOCA110N
<br />AT'N: ':OgRC3 ~. eE:CC.~:Y, ;r,N T.9L ATN!
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
<br />DISCHARGE MONITORING REPORT (OMR;91
<br />Ct0927i5Y ^7F ?~
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM '~ ' ~ TO ' ~ I " "
<br />lzazll (zz-z~l !z4-zs) Rbzrl !ze-zs) !,w-31)
<br />.•. .~.
<br />Form Approved.
<br />. \ , ^ , OMB No. 2040-0004
<br />' ° - Approval expires 05-31-98
<br />v r+l? \ n. '\ ? Tr! FfTI nCL ^nF'C%
<br />NOTE: Read InsVUCtlons before completing this form.
<br /> (3 Card Onty) QUANTITY OR LOADING (4 CaM Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br />PARAMETER (4653) (54-61) (38-45 48-53) (54-87 E7( OF TYPE
<br />~~~ AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNRS
<br />pizall ANALYSIS
<br />(54-98,
<br />6370
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<br />NAME/TRLE PRINCIPAL IXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF
<br />RM
<br />M F
<br />Wmi THE INF LAW THAT I NAVE PERS
<br />ATION SUBMITTED HER ONALLY DfAMINED AND
<br />EIN
<br />AND BASED ON MY TELEPHONE DATE
<br /> AMNAA
<br />A
<br />O
<br />OSE INDNIDUAL ;
<br />S IMMEDIATELY RESPONSIBLE FOR OBTAINING
<br />Richard Mills INQUIRY OF TH
<br />THE INFORMATON, I BELIEV E THE SUBMITTED INFORMATION IS TRUE, / ~~
<br />'~
<br />'
<br />'~~ .;-
<br /> ACCURATE AND COMPLETE. I AM AWARE THAT TMBRE ARE SIGNIFICANT ~ ~~
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<br />7
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<br />Environmental Manager PENALTIES FOR SUBMITTIN G FALSE INFORMATION, INCLUDING THE ~
<br />D 87
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<br /> FvSSieilri uF FNE AND iiAPR iSOFiMEilT. SEE ttl U.S.C. 910D1 AND 33 U.S.C. SIGNATURE OF PRINCIPAL IXECUTIVE 9.\
<br />
<br />TYPED OR PRINTED § 1319. (Penettia\ under These sleh4es msy Include lures up m 310,003 entl ar
<br />merimum Mpnsonmerrt of benreenemanllY end Syeers.l OFFICER OR AUTHORIZED AGENT
<br />p I
<br />NUMBER
<br />YEAR
<br />MO
<br />DAY
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<br />COMMENTS AND EXPLANATION OF ANY vIULAI IVN, (Nererence au anecnmenrs nere)
<br />ALTERN1TF Li"IIT~ er)R TS S, [4JN S SRTTLFA3L8 SOLIDS (L'1C f7'1 iPPi,• n\'i.• TP C= 1"-r of ~~~_•{v rRPCIP FTRNT
<br />IS CLAIME^e SBE I.A.2, ?~ 1R, PDR ~IOR~FN lP P4'70R RFIIIZP.!!P.y"C. nTi, f. !'^%A'^-'-~- '~^^^•'n^`o F/, Pf; ~.
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<br />EPA Form 332o-i (08.95) Previous editions may not be used. (REPLACES EPA FORM~T-40 WHICH MAY NOT BE USED.) D I7 T ~ -r / q T D II 7 2, T 5 ~ TI PAGE = OF
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