Laserfiche WebLink
PERMITTEE NAME/ADDRESS (include Farilirv Namr/Location t/Dr$rrrntl <br />NAME sereCA COAL Ccr.fFRY <br />ADDRESSDr.AWeQ D <br />NAYUEN <br />CO 41699 <br />FACIUn <br />LOCATIOI~AYDEN CG b163U <br />ATTNi G. 9UD BROYq, GkRF.HAL !!ANAGEN <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISC(HA6 GE MONITORING REPORT (OMR;9J <br />0000E I C ~ <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PE IOD <br />Y MO DAY YEAR MO DAY <br />FROM 1 TO ~ <br />"3) (2Y25) (26"11) (2e-28) (3031) <br />Fprm Approved, <br />A I N G R OMB No. 2040-0004_ <br />Approval expires 05-35'•~B <br />(SUhH r1) <br />F - fI11L ~L41 <br />ACUTE AFT LF51316 FCh CC°A <br />ti4 NC LI'CEAFCF ~__~ ~'~~ <br />NOTE: Read Instructions before completing this form. <br /> (3 Cerd Onty) QUANTITY OR CO ~ <br />' (<Certl Only) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (4B-53) (5a-51) " ~ (38-45) (46-53) (54-67) EX OF TYPE <br />(32-37) AVERAGE MAXIMUM MINIMUM AVERAGE MAXIMUM UNITS <br />(62 a3J ANALYSIS <br />(64-6a) <br />69-70 <br />1U tlHR 8 L SAMPLE `t >a a" CAY 4". O OtIG O+C:C: ( ~,;) ' <br />MAGRA MEASUREMENT ` <br />/ (~..u O V ~~ <br />IAR9C 1 U U } <br />$~ <br />- <br />'-~~'EAM441 ail i S~t~ <br />,'r 0 E11- ( F 7 iiAB <br />:F'FLUf?NT GROSS YALUk T <br />~~ <br />, <br />iPCCUf~EtJf~i~T ~~ ~ `'~`- sih~ ~~ k ~ ~~~ il=~~ CE17 <br /> SAMPLE <br /> MEASUREMENT <br /> j }4 <br /> <br /> SAMPLE <br />MEASUREMENT <br />c Q O p C ~- <br />~ / <br />lL <br />p y <br /> ~ <br /> ~~ , r' - - ~ ~ ,3,~- <br /> <br /> SAMPLE <br />MEASU <br />R <br />E <br />MENT <br />t <br />~ ~,. <br />vf~ `~ C P r <br />(Z v <br />5'E? ~ -I <br />C~ ~ k. (V S ~r, <br /> { ~1 <br />~D~~•/ <br />' T <br />¢ V• <br />~ <br />c <br />If yT . <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> ~C3 EMENT <br />-.,.: ~ ~' <br /> SAMPLE <br /> MEASUREMENT <br /> y ' <br /> '~EE;l~11REM~l~'~ ~ ,. <br /> SAMPLE <br /> MEASUREMENT <br /> <br />~pUIBEM~NT;~` ~ I <br />S <br />NAMERITLE PRINCIPAL E%ECUTNE OFFICER I CERTIFY UNDER PENALTY OF <br />LAW THAT I HAVE PERSO <br />NALLY E%AMINED AND TELEPHONE <br />DATE <br />AM FAMILIAR WITH THE INFORM ATION SUBMITTED HER EIN; AND BASED ON MY <br />INQUIRY OF THOSE INDIVIDUAL S IMMEDIATELY RESPON SIBLE FOR OBTAINING <br />THE INFORMATION, I BELIEV E THE SUBMITTED IN FORMATION I$ TRUE. <br />ACCURATE AND COMPLETE. <br />PENALTIES FOR SUBMITTIN I AM AWARE THAT TH <br />G FALSE INFORMATIO ERE ARE SIGNIFICANT T <br />INCLUDING THE <br />N y <br /> <br /> <br />POSSIBILITY OF FINE AND IMPR <br /> <br />ISONMENT. SEE fe U S. <br />, <br />C. 4 1001 AND 33 U S.C. SIGNATURE OF 9 INCIPAL EXECUTIVE ' <br />1 <br />TYPED OR PRINTED ~imum~~lonment ol5etween6r~ironM5 and 5uTtl~e Sirres up ro t10,000 end ar OFFICER OR AUTHORIZED AGENT CR E <br />NUMBEfl'ti; <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re/erence all attachments here) - <br />3r6 PART L.A.4 F'Ch Cf7AIL5 OF TEST PeOCEUUAF. RELCFT LCrEST CILUTICI (+" EFFLUEII) MbICi15 IFTIAL 7C <br />SU:: OF TEST GAGAfI9!_ (LCSO) ANC ATTACH ACUTE TCIICITY TEST REPCiT lcbn TG DHh. CC6IFS CF ALL <br />TJrcCtIiLA_TT^- N9.C~ ..E-F s.•1.r°~: T4._FflA <br />EPA Form 3320.5,(ORF95).; PrGgious editions maynpt be~us.(<d;, '~•(REPCA,CES EPA FORM T-40 WHICH MAY NOT~E~41SED,) COUS3/990 8:7-165 ~ PAGE I OF <br />