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PERMITTEE NAME/ADDRESS Q•rbL t:mry Nun..•Loraum gOg..,r) <br />NAME t323AH COAL CGtlr3AtiY <br />ADDRESS BEflx NU• 3 tlINr: <br />F.O. BUY 518 <br />SUAtitlSEl' CU 81434 <br />FADILITY <br />LOCATION <br />flT•rel: DArIEL blflx, ;".Ihc riaNACSd <br />NATIONAL POLLUTANT DIBCHMGE ELIMINATION SYSTEM INPOESI <br />DISCHARGE MONITORING REPORT IOMRI <br />11-161 /17-191 <br />GuGU44 77. 4 <br />PERMIT NUMBER DISCHARGE NUMBDI <br />. MON 0 .G PERIOD <br />YEAR MO k9~ YEAR MO DAY <br />FROM J ~'r0 ilk <br />no-zu rzz-z31 /z rzs-zn ns-zsl r3a911 <br />iiJNUFF Tli N FR <br />(SUdh iIC) <br />F - FiNA.. <br />rilNOii <br />Form Approved. <br />c tPM@S's~c~A4O~'P94 ~ <br />ApprovelixP3ei,,05-3 -98 <br />~r~= Nu DISCddxJz ~~~ ~r~ <br />NOTE: Rud Irntruetio0e bdon eompktlnp thie form. <br />PARAMETER l3 Grd Onlyl CUANTITY OR OADING l~ Grd On/`I GUANTITY OR CONCENTRATION NO FREQUENCY SAMPLE <br /> 146-531 /50-611 136451 !4653 I5b6/I OF <br />137-371 EX <br />ANALYSIS 7yPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 163 <br />eJl <br /> - /64691 /69-701 <br />OIL AND ~n E;A~E: SAMPLE ;k,-k;Y #.rt: '( 94) #:xIR>aIp1:0 ,-:~+#;::~ ~.~=~+: <br />V i~ U Ai MEASUREMENT <br />84vUb ~ lV ~i PERMIT #L~$AI# xEx~oxT nS=1 %:~'r`Y+ <br />N '::. %Y."+~kT~t3~ #irYF~?Y%3 -".=3:i• 4BiKL YISUA <br />BYl•LUENT ii ti li:i5 YALU REQUIREMENT <br />IBST BAY <br />:+U=v '• '" ` .,. <br />~.:Y.. <br /> SAMPLE <br />MEASUREMENT <br />~(~ <br />~$C~,rQ <br />~ J <br /> PERMIT ~~ <br /> REQUIREMENT ..;~'. .r~.. ~ ~ ~~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ~ ~~ <br /> SAMPLE <br /> MEASUREMENT ' <br /> PERMIT <br /> REQUIREMENT ~ .. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ .. <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ~ ~ . <br />NAME(TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY E%AMINED AND <br />AM FAMILIAR WITH THE INFORMATION S <br />BMITT <br />D <br />E <br />E <br />B <br />' TELEPHONE DATE <br /> U <br />E <br />H <br />R <br />IN; AND <br />ASED ON ~ <br />~ <br /> MY INQUIRY OF THOSE INDINDUALS IMMEDIATELY RESPONSIBLE FOR <br /> OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS <br /> TRUE. ACCURATE ANp COMRETE. I AM AWARE THAT iMERE ARE <br /> BIGNIFICANT PEMALilES FOR BUeM17TING FALSE INFORMATION <br />INCLUDING <br /> , <br />THE POSSIBILITY OF FINE ANO IMPRISONMENT. SEE 1B U.S.C. 7 1001 AND 33 SIGNATURE OF PRINCIPAL EXE <br />T <br />E ~ 9- <br /> LLS.C. f iG1Y. IP,rWPia MW~r INS ,RrNba rrvY MrJur, ~ , up ro i IO,IXlO CU <br />IV AREA <br />TYPED OR PRINTED nHwm,TMlrunimpddnwnr Prhrw«n emonm, ra6vA,n1 OFFICER OR AUTHORIZED AGEM CODE NUMBER YEAR MO DAY <br />C VMMtN I S ANU tXYLANA I ION VH ANY VI VLA I IONS !Reference el/ ar/eohmen ES ABlel \ <br />1'SS c TGTaL IeJn' LL:iTS ~'rLL 8S IiAIYbil, ANi SnTTLcAbi,: SOLIDS LItiIT APPLIED POET <=1t1Yx,24Eix PxECIF EVENT; <br />TSS, lEtL:N AND S£TTLEABLc SOLIDS LItlITS iIAIYEll FOB >lUYB,24dLi Pi1LCIP EYEdT-ATTACd GOCUriENTl2I0N-SEE I.A.3. <br />Z f' -- T _ 7 5 C ~ p <br />EPA Form 3320-1 106-951 Previous editions mey be used. REPLA ES EPA FO M T H C AY NO ~ 8 .I r PAGE OF <br />• - ~~ tiVLi74/96~iLI2-0943 i <br />t. - ~ ,,. ".;, ~ - <br />