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PERMITTEE NAME/ADDRESS (/noluCe Facilip•NamelGnemion JOPrrcnp <br />NAME CYPRUS EMPIRE CORPORATION <br />ADDRESSEAGLE MINE COMPLEX <br />P. O. DOX 68 <br />CRAIG C:O 81626 <br />FACILITY <br />LOCATION <br />Al"7N: AGEURGE E. `JAJDA, V P <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SVSTEM (NPDESJ <br />DISCHARGE MONITORING REPORT (DMR) <br />CUOU34142 022 A <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR M DAY <br />FROM v va TO '~ <br />Form Approved. <br />,,:: IJOR OMB No. 2040-0004 <br />(SUDR NW) <br />F - FINAL MOFAI <br />SPOILS SP WTRq~5EEP/WILLIAMS Fh <br />u## NU DISCHARGE I_ I ~~~ <br />NOTE: Read Instructions before completing this form. <br /> QUANTITY OR LOADI ~'~ ,;,. QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER .: EX of TYPE <br /> <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS <br />ANALYSIS i <br />SULL 5. I U <br />DISSOLVED SAMPLE itiFRiFUU ~~~- ~•~ **~ <br />~0~0 '~Ro ' ~ ' IG,- <br />~ GRILB <br /> MEASUREMENT ) ! <br />70295 1 O O PERMIT a~r,.~ r' <br />EFFLUENT GROSS VAL.Uf 'REOUIREMENT #~'_ ;?F~r~ _ <br />fiRTR AV8 IpRTR MAX MG/L <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~~, ;_ r <br /> REQUIREMENT <br />si.~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~~ ~;~~ <br /> REQUIREMENT " <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT °" ' ~+' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />~ <br />~ <br />~ ' <br /> REQUIREMENT .'x+. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ -~'!'~ '. <br /> <br />REQUIREMENT _ <br />~ <br />:v <br />~ ~ <br />~ <br />_ _ <br />NAME/TITLE PRINCIPAL E%ECUTIVE OFFICER I Certiry under penalty of law that tms document and an anachments were <br />~ TELEPHONE DATE <br />Y: µ. r 1 d U IVI111 ' prepared untler my deection or supervision in accartlance with a system tlesignetl <br />to assure [hat qualdietl personnel properly gather antl evaluate the information <br />~ <br />FIl`/IYOCI r'lf'l t.^.I r.~01'IRC)CY submittetl. eased cn myingwry of the person or persons who manage the system, <br />the informatipn <br />or (hose persons tlirecny responsible for galhenng the udormation ~(/l/ <br />'/~ r <br />- r]]tJ-Q]Q-2]~~ ;y <br />d/ ~r ,~if <br /> , <br />subminetl is , to the best of my Nnpwletlge and belies, true. accurate, antl complete SIGNATURE OF PRINCIPAL E%ECUTIVE <br /> <br />TYPED OR PRINTED I am aware that there are signilmant penalties for submining seise information. <br />inclutl~n the ossibili of Gne antl im risonment br knowin violations OFFICER OR AUTHORIZED AGENT AR <br />ODE <br />NUMBER <br />YEAR <br />MQ <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />F"LOW LIMIT APPLIES TO COMDINED FLOW FROM 003, U22 8f 024 DIL Ra GREASE GRAB SAMPLE ANALYSIS REQUIRED TF <br />VI5IDLE SHEEN IS OBSERVED. QRTRLY SAMPLING INSTRUCTIONS-I.C.B. PG X <br />EPA Form 3320.1 (REV 3/99) Previous editions may be used. 00193/ 0004LTNIS 1Sy~4;pART FORM PAGE 1 OF <br />