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<br />NAME. ,~OWilSFAHCIRN COAL C,U lLPAIIT _ .-
<br />ADDRESS$DADSIDE lIINE, Y E S PORTALS
<br />P.O. 60Y 147U
<br />PALISADE i:0 81526
<br />FACILfTY
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<br />NAMERRLE PRINCIPAL EXECUTIVE OFFICER I cERTI
<br />AM FA FV UNDO( PENALTr OF
<br />MIUM WITH THE INFO uw THAT I HAVe PERSONAILr ExAMweD MD
<br />RMATION SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE
<br />Ir~ /\ 1
<br />G J I (~ ~ t l( MY INQUIRY OF TXOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE fOR
<br />OBTAINING THE INFORMATION, I BELIEVE THE 9UBMITTED INFORMATION 19
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<br /> TRUE, ACCUMTE MD COMRETE. I AM AWME THAT THERE ME
<br />INCLUDING
<br />SIGNIFICANT PENALTIES fOR SUBMITTING FALSE INFORMATION _
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<br />Q e Fl - THE POSSIBILITY OF RNE MD IMP/1150NMENT. SEE 18 U.S.C. 1 1001 MD 3] SIONATUIIE OF PRINdPAL E%Ed1TNE
<br /> U.S.C. f 1 ]1 e. lPwWO„ uM~r Trw mem, rn,Y ~'NAA, rnr, Ip ro ! 10,000 AREA
<br />TYPED OR PRINTED Wwmuinrn irm~iaa,rNnraMnrwnese.ar,weYwr,/ OFFICER OR AIfTHORIZED AGENT eoDE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lFs/erence s// sffeehmenfs here/
<br />si:TTLF:ABLE SOLIDS LIMITS -PPLIES ONLY IF <=l0YR,24RR PRE~IPITATiON EYEN2 ZS CLA11lED. PrANITTEE NAS
<br />:;J&DdN OP PROOF WREN AEQU£STING RELIEF FP.OM SETTLEA6LE SOLIDS PRIMARY LIRITATIO{S.
<br />EPA Fwm 3320.1 108.96) Previous editions may be used. (REPLACES EPA FORM TAO WNICN MAY NOT BE USED.1 C 04 5 7 / 9 8 C ~ ~ 3-12 5 5 PAGE 1 OF
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