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PERMITTEE NAME/ADDRESS (Include Focihlr Name/Location i/OPerenq
<br />NAME CyP°US YAP;FA VALLEY COAL rONP.
<br />ADDRESSILR°5 1, 2G,! `CUTri, v FCY IA S; L'i~
<br />y~OU EhST ~"I::'!kFL CIkCL`_'
<br />F.:;1.F'ApOD ''n %t0i'9ti
<br />FACILITY
<br />LOCATION
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<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDESf
<br />DISCHARGE MONITORING REPORT (OMR~
<br />CGt)i12715U 005 A
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM I'mo' u4 ul TO uu u4 ~u
<br />(2P211 f22-231 (2d-251 (26.111 (2829) !3031)
<br />Form Approvetl.
<br />M A ~ l _ OMB No. 2040-0004
<br />Approval expires 05-37-98
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<br />(32J7) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE ~ MAXIMUM UNITS
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<br />(64-ss)
<br />69.70
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED AND TELEPHONE yI~„~ DATE
<br />~'' ~ -
<br /> AM FAMILIAR WITH THE INFORM ATION SUBMITTED HEREIN; AND BASED ON MY ,
<br />
<br />Richard Mills INQUIRY OF THOSE INDIVIDUAL
<br />THE INFORMATION
<br />I BELIEV S IMMEDIATELY RESPONSIBLE FOR OBTAINING
<br />E THE SUBMITTED INFORMATION IS TRUE ~ ''
<br />
<br />
<br />Enviro~mantal Magager ,
<br />ACCURATE AND COMPLETE.
<br />PENALTIES FOR SUBMITTIN .
<br />1 AM AWARE THAT THERE ARE SIGNIFICANT
<br />G FALSE INFORMATION
<br />INCLUDING THE
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<br />970-R70- 12
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<br />POSSIBILITY OF F
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<br />. § 1001 AND 33
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<br />i SIGNATURE:OF PRINCIPAL EXECUTIVE
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<br />TYPED OR PRINTED §
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<br />maximum lmpnsonment of beMee felutes may inclutle l
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<br />OFFICER OR AUTHORIZED AGENT
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<br />NUMBER
<br />YEAR
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<br />EPA Form 3320.1 (OS-95) Previous editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) I PAGE OF
<br />00,1/OJC4(,5-1'IOi 1
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