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<br />PERMITTEE NAME/ADDRESS (h.cbJ. F.eJ~ryNaWToranar dD~,..ly) <br />"^"~ ADYDSRNCiRH COAL CORPANY - -- <br />ADDRESSHOAOSIDF ..":I'NF, N & S PORTALS <br />P.U. SCf ld3C <br />P7CLI5Ali? CO SI~2b <br />FACILITY <br />LOCATION <br />xTTN: JOHN A. `I:!:At3, F.;n~IDEi1T <br />~ PERMIT NUMBER I ~ DISCNMGE NUMBER ~ <br />MONITORING PERIOD <br />YEAR MO DAV YEAR MO DAV <br />FROM L 0 TO 01 12 31 <br />!16111 l27-131 111-761 !74771 l7B-791 130-31) <br />- _ - ~ _- ~M-Approved. ~- - <br />iCU2Z-1fLTYE~T3' .110°-°'~Q~Q ~° ° ~ - <br />(3U9R fiC) e1 e505-31-90 <br />F. - FI KAL 1 .3 <br />MfINOR - - - -- - - -~ <br />##4 RC DISCRARCP, ~ ~'^~` <br />NOTE: Reed inetructiolr belor completing thb form. <br />- -PAitAMETER !3 Grd Onlyl QUANTITY DR LOADING !1 Ord Onlyl QUANTITY OR CONCENTRATION NO. FREOUD+cC AMRhb- <br /> !16531 !546/1 l3B-151 144531 !64611 OF <br />l37-371 EX <br />MALY94 TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS I6I-eJl !64661 169-701 <br />i.CSU STATR}; 4aHk AC SAMPLE 04~#> ~r3i:tY w~a;:#; z:x#4ya0 ( 23) <br />C:ERIOUAPRNIA MEASUREMENT <br />:AItijU I 0 U PERMIT #gltr04.oY FYIRQIS'#~ rArY: 1aD.0041 ~'~'~$'#~ 7~n>f#~ BA- TRLT ARAB <br />c•r}•LU r.NT GROSS YALUF REQUIREMENT - ~ <br />~ ~ ~~ ~~ Dot <br />i. L:SU 5TA'l NE 95ri3 AC SAMPLE p#~ <br />aau aaosa>r maOSIOD #C~### ( 23) <br />P IiiEPRALES MEASUREMENT <br />f R VbC I 0 U PERMIT ~~ ~IS.'O:Gv'~~-F: ~ ~ ~ .~.~i4a!a~#?a ~. ~aa ~~.RD..QQQ1' ~ . ~' ~+R `R~O~~ :. .. ~.' it#I##04:~. ER" : ~RLX ~iflAB <br />i.F}'LOENT GROSS YALOt REQUIREMENT OA~tY c <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br />' MEASUREMENT <br /> PERMIT ~ ~~ <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ - <br /> REQUIREMENT : <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT.. <br /> REQUIREMENT ~ : <br /> SAMPLE ' <br /> MEASUREMENT <br /> PERMI.T.~. <br /> REQUIREMENT ~ ~ <br />~ ~ ~. <br />NAMERITLE PRINCIPAL EXECUTIVE OFFICER I cERDFr UNDER PENALTY <br />oF <br />AM FAMILIM WITH THE INFO uw THAT I HAVE PERSONULr EAAMINED MD <br />RMATION SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE <br />3- r ~~ 1~ J F f- <br />C MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOP <br />OBTNMINO THE INF011MATON <br />I BRIEVE THE SUBMITTED INFORMATION IS <br />- , <br />TRUE <br />ACCUMTE AND COMPLETE <br />I AM AWME THAT THERE ME <br /> . <br />. <br />SIGNIFICMT PENKTIE9 FOR SUBMITTING FALSE INFORMATION <br />INCLUDING q <br />1 <br />9 <br />it 7 <br />AS e ~~ . <br />THE POSSIBILITY OF RNE MD IMPNSONMENT. SEE 18 U.S.C. ! 1001 MD 37 <br />610NATURE OF PRINCIPAL EIEECUTNE 7p <br />/ !/~, )~/e1 <br />L <br />V d~ l~ I O <br /> U.S.c. E 1 Sts. IANWMI InNI eMY .soma m)y hckW hss y ro s IO,OBO AREA <br />TYPED OR PRINTED .ntlwma.irlvn lnpn'aonnwrr a/btr,.nemanas.w6y..zl OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAV <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re{ennn sll e{Techments here/ <br />:,EE iAKT I.8.11 FOR L`ETAIL3 OF TEST PROCEDURE. REPCRT LOi12ST DILUTION ('~ EFFLUFKT) YHICN IS LF~~'fNAL TO $0; <br />Gr' 'fcST ORGANISMS (LC50)~ AND ATTACH ACUTE TOILICLTY TEST P,HPCR'" FOR!! TC C(!P.. COPIES OF ALL INFORrATION <br />IIGT T le ll <br />EPA Form 3 20- 10 -95 Prevloue editions mey be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.) C C R 0 2 ~ 9 9 C 2 2 3-12 S ti PAGE I OF <br /> <br />