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PERMITTEE NAME/ADDRESS (Include Facility NamrlLocario¢ if D~erenQ <br />NAME <br />GLUE tgpUNTAIN ENERGY, INC. <br />ADDRES$i,:SERADC MINE <br />3L0? COVNTY ROAD 65 <br />FACILITYRAIVGI-.Y '."^ B.6AL3 <br />LOCATION <br />r r+ni. iccr r:mntcr <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDESJ FOrm AppfOVed. <br />DISCHARGE MONITORING REPORT (OMfl) OMB No. 2040-0004 ~ <br /> M 1 NCIH <br /> <br /> r' (SU3F? NW> <br /> PERMIT NUMBER DISCHARGE NUMBER ` ._ FI NAL R S _.Afd <br /> MONITORING PERIOD SDH#h SUMP DSCHRG TO vYD WAS`i <br /> YEAR MO DAY YEAR MO DAY <br /> <br />FROM <br />OO <br />11 <br />01 <br />TO <br />00 <br />I 1 <br />3() <br />nv~> NO <br />DISCHAF?GE _ <br />f ~I ~+?~+~ <br /> NOTE: Read Instructions befo re completing this form. <br /> QUANTITY OR LOADING QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br /> EX of TYPE <br />PARAMETER AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ~~Is <br />'FI SAMPLE #a+tair iz tr irr#at# tu:a-c as 1~'1 <br /> MEASUREMENT <br />~Or3U6 1 f) O ~ .PERMIT ~- ~ ~iHt-~F4F,3BOF- ~ ifl~~IF'k~u- 4F as $ _ it#ir~R±r# O W EK1:Y ~. T4't) <br />_F r.JJE^" I 6ROS:i VALUE REQUIREMENT ~ .~.~~ .!+} I ~ M 'al <br /> <br />JUL. 1 D5. 'TO 1 AL. SAMPLE #itat#ttu ~tt~-aa a 1" ; <br />Ali°~'Fid`%ED MEASUREMENT <br />Jr' .,O i (' 0 ~PERMIY :. = #~!'~'N1N- ~~M{F1FM~. ~" a+r ~ -,~l ": O C'E/ ~ pAB~ <br />F' Lt1E7JT GiZC5S VALUE REQUIREMENT a+la AV DA V X 1C 'I 'f'H <br />r RDN. Tt:.l-A! . SAMPLE ~tr+t~aa #~x ar## `I ) <br />f A5 FE) MEASUREMENT <br />)1^45 1 C O ~ ='PERMIl~ '#~'~'16l-i~+ " <br />~ a~ ~~!.. ~,:~ O (+)~l'~ ~~ <br /> <br />,f'FU.)ENT GROSS VALUE <br />REQUIREMENT <br />~'' <br />#~# <br />VG <br />I) SL <br />1i;',. r <br />IL APJU GRE45E SAMPLE -X-a+r#irfr -Ira"iFil'#iF tr-IFiE9ririt -a#'n* "ry'r : . <br /> MEASUREMENT <br /> <br />~,~`.'ri ~_ 1 0 - `J <br />'-PC'RMIT.. <br />~ 'ifAF'~F~`1R~±~ ' <br />_~-iFl4liE'11~~ ~ <br />#ir <br />~ i#A.1'!'N'3!- - <br />4Fikif##ir <br />Q <br />~. <br />.~ rte., <br />~~IS s•: <br />~F~ F~i_UENT Gi~OS6 VALUE REQUIREMENT "" a"qtr ~ 1S X G L - <br />"L041, ItJ CONDUIT OR SAMPLE :i;: ` x-trit#to-# ~uz. it c -~ 4 " n";. >. <br />-iFrt) TR Er~TF1ENT PLANT MEASUREMENT ' <br />.0070 ;, O O "PERMIT. ".REPQRT~' 'REPf~T **s~tsw; *~~#a~ ~+r~t~a-x # W ~iILY NB~T/cN <br />"I"FLUFFJ.i BROSS VAUJE REQUIREMENT" 0 A A A Y. 1GI. <br />I;_ AND GREASE. SAMPLE ara~aa"a~ y'i- a"~at:~;v -+.. ,- - .. <br />r ; 611AL MEASUREMENT <br />'4C6F_• 1 *_' C 'PERMIT }Ht~r*#+r 12EPC7RT Y _:;_ t a+r+rirsr~ at;r-a*t~~ s+a'.aana -x ". ,. W EKL: I$UAL <br />i1=}'LIJENT GR USS VALUE REQUIREMENT ,.IN l0:=0 - <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ __. <br /> REQUIREMENT. . "- " ---- - - <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I Cer01y untlar penalty of law that Nis tlocument and all atrachments were <br />h <br />i <br />d TELEPHONE DATE <br />- <br />, <br />_ a system des <br />gne <br />prepared untlar my dlreclion or supemsion in aarortlance wit <br />/ <br />f <br />j~-~_~,,.~ ~ r~t~, .i_ to assurethat qualified p¢rsonnel properly gather and evaluate the lnlormation _ __.,' ~,.-f' <br />I L ~ ~ subminetl. Basetl on my inquiry of the person or parsons who manage the sys0am, <br />` r ' ! ~ ~ <br />~ <br />~ <br /> the Inlormetlon <br />or those persons dtr¢Ny responsible br gaNering the iinormatlon - ~ <br />~" ° - <br />~` <br />- <br />+ <br />('~>~ , <br />e end belief <br />true <br />accurate <br />end complete <br />in <br />t <br />b <br />f m <br />knowled <br />b <br />d I <br />th <br />t " ' <br />' -~~' ( <br />. <br />u , <br />, <br />y <br />, <br />. <br />su <br />m <br />e <br />s, <br />o <br />e <br />es <br />o <br />g SIGNATURE OF PRINCIPAL EXECUTIVE 1 ~ <br />~ ' 'f ~ = . <br />- ? ' < <br /> <br />TYPED OR PRINTED lam aware thatthere are signmwnt penalties br submiWng false inbrmatbn, <br />indutlin the ossbih olfine and im risonment brkmwin Notations. OFFICER OR AUTHORIZED AGENT A <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANV VIOLATIONS (Reference all attachments hare) <br />IL NO DISCHARGE OCCURS, REPORT "tJU DISCHHRGE" ~N I)MR G :_ ~; `:;t i ,~ ..:+ +y~ ,'~.', 'L ~ F;~•NPI_Ihit <br />INSIRUCTIE7tV5 - I C f3. F'. XI <br />EPA Form 3320.1 (REV 3/99) Previous editions may be used. THIS IS A 4-PART FORM PAGE OF <br />