Laserfiche WebLink
<br />PER[u11TTEE NAME/ADDRESS (IK(udeFaci(iryNmnelLocalian JOge.at) <br />NAME'. CL'LOYTO COAL CCF`PAHY, L.F+. <br />ADDRESSCOLOY[0 NINE <br />5731 STATB NIGHNAY 13 <br />NEf:KER CO 81641 <br />FAauTY <br />LOCATION <br />FRS <br />ATTN: J. D. HARMOY, GENERAL lyR~AGEii <br />Form Approved. <br />M j N O R OMB No. 2040-0004 <br />(5UBR NY) Approval expires 0637-98 <br />F - FINAL MOFA2 <br />STRZETHFt GULCH TO GOOD SPGS CR <br />%Sr RO DISCHARGE ~~~ #++~ <br />NOTE: Read InsVUCtions before completing this forth. <br /> (3 Certl Ony) QUANTITY OR LOADING <br />~ <br />~ (4 CetA Ony) QUANTITY OR CONCENTRATION NO. FREOUEN SAMPLE <br />PARAMETER (4&53) (54-fit) ~ '~ <br />i' (38-45) (46-53) (5461) EJ( OF TYPE <br />(32Jn ~ AVERAGE MAXIMUM U S MINIMUM AVERAGE MAXIMUM UNITS <br />r6a371 a~a.YSls <br />(64-68 <br />6370 <br />L Ir lrU btlLe JG SAMPLE •••••"~grc 74j *~##iFF XRF ~9~~ x".9T. AG tl,~ <br />I <br />~ <br />T I 5 U A L MEASUREMENT ~ Q /c1O 13 ut~ <br /> _ <br />eu066 1 0 0 ~ PEflMI_r.. ~ ~ <br /> <br />` <br />" ` • E5=1 <br />~~ ~~ ~r <br />EFFLUENT G$OSS YALUF ftEOGIREMEIJT ;*~ <br />.- T} <br />~ NO=O ;` ~m'k:±+3;~s~ 461SY• mfi ' <br /> SAMPLE ~ '~ <br /> MEASUREMENT I <br /> PERMIT,t,T.; , <br />' ' <br />~ <br />' ~ <br />+ <br />' <br />~ F <br />s <br />,.d <br />L-. <br /> EQUIREMENT %, <br />' ¢ ~. r o~ ~ ~ <br />$ . <br />, ~ <br /> SAMPLE `~ ~~ <br />- <br />• MEASUREMENT ~ +~ <br /> ,,.; <br />~" • <br />".. <br />~~ <br />t <br /> ~REOUIREMENT <br />~. <br />~ ~.• ~, ~,- `~ •~ <br />... <br /> SAMPLE `, F..>' <br /> MEASUREMENT y ,_ <br /> ~~,~PERMIT~ t~. <br />~ <br />` ~ Pte. ~ ~. <br />x <br />$ <br />~~ u•+~,.,,: <br />" - « "- <br /> REQUIREMENT <br />~. ~: <br />' <br />~ <' <br />~ ~ <br />' <br />N "' ` <br /> , , <br />. ,. - <br />. _ <br /> SAMPLE <br /> MEASUREMENT <br /> .fib <br />~PERMIT~S r ~;~ <br />~ rz3-T x .r <br />yrF,- 'i'S* <br />~ ~. " `~"' <br />~y ,t, f! <br />~ <br /> REQUIREMENT, a ' ~ ~, ~, m t ,~, ,~, ~. ;~ ,k ~~ •~,:.~ ~ ~ <br />~~. <br /> SAMPLE <br /> MEASUREMENT <br /> } '''" <br />' <br />~ <br /> rREQU1ftEMENT ~ ~,~ Y ; <br />s a ` w~ ~' <br /> -- , <br />, i <br /> SAMPLE <br /> MEASUREMENT <br /> ~H.I«" <br />~„wy;PE,RMIT~ ~ ''.a ~ ~ vJM' <br />X ~x * ~ -.~,'. Yiy. M1ii .;~ <br />4{ -,X4 <br />' <br />" j~ gk4 ~ ~ <br />~4{ 3fif°' 3- <br />~ <br />- nY ~i P S. ~,' <br />~~ <br />'! ~' ~ <br />~ <br />' 'R(~~^['%~~' <br />x' <br /> REQUIREMENT; pia, <br />F <br />~' <br />y. :«r~ ~a <br />~ -:rat ~:,: <br /> , u <br />, <br />•, a a <br />NAME(TRLE PRINCIPAL EXECUTNE OFFICER 1 CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSO NALLY EXAMINED AND TELEPHONE DATE <br /> AM FAMILIAR WrrH THE INFORM <br />INQUIRY OF THOSE INDIVIDUAL ATION SUBMITTED HER <br />S IMMEDIATELY RESPON EIN; AND BASED ON MY <br />SIBLE FOR OBTPINING ~ <br />~ <br /> THE INFORMATION, I eELIEV E THE SUBMITTED IN FORMATION IS TRUE, t <br /> ACCURATE AND COMPLETE <br />N <br />ES <br />OR <br />UB <br />nN I AM AWARE THAT TH <br />F <br />R <br />TI ERE ARE SIGNIFlCANT <br />IN <br />OI <br />T <br /> <br />r TYlO h , PE <br />ALTI <br />F <br />B <br />MIT <br />POSSIBILITY OF FINE AND IMPR ALSE INFO <br />NG <br />HE <br />G <br />MA <br />ON, <br />CW <br />ISONMENT. SEE 1B U.S.C. § 1001 AND 33 U.S C. <br />SIGNATURE OF PRINCIPAL E7(ECUTNE //y~ ~r rr~~ <br />•1 / V //~~/J <br />TJZ ~~ <br />~ Q ' 1 <br />4 y <br />~ ! <br /> <br />TYPED OR PRINTED § fate. (PensNes untler Nesp smtutes nMy Include linty up m 510,000 Mtl rr <br />meamum impdsonmenf of SeMeen 6mm~rns end5yeers.) OFFICER OR AUTHORIZED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND E7(PLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SEYTLEAULE SOLI D5 LIlIIT APPLI65 UNL[ IF <=10 [R,24'.NR PRECIP HTEYT IS CLAIMC6.` IF CLAIM APPYOIED BY MQCD, <br />TSS 6 IRON LItlITS YIL1 YOT BE APPLIEiI TO REPORTdD~AEAS08E[IENTS - SEE I.a.2r PG. 5 FOR BUYDEY OY PROOF <br />EPA, Form 3320.7 (OB 95) Previous editions may not be used. (REPLACES EPA~FORM T-40 WHICH MAY,NOT BE~l1SED'.)' - PAGE OF <br />,..., <br />.-a ~ ~_ ~ •,- sY +1J990505--1 1~, <br />w:.. ,. .. <br />- _ ...~.., -t_~_., .._ .... .-. <br />