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FERM1ITEE NAME/ADDRESS p~.AdrF.NryN~lrrfw yotpL..,n) <br />NAU1E _ FOaDERBOAB COAL COdPANY <br />ADDaessROADSIDE MINE, Y E S POkTALS <br />P.O. bOS 1430 <br />PALISADE CU B1S26 <br />FAaLm <br />LOGTION <br />ATTN: UONN CHLCKEkZNG, UYhER <br />AVERAGE <br />#aaaa# <br />CERIOD-PtINIA IMEASUREM <br />rin38 1 0 0 PERMIT <br />ZFFLUENT GRO55 YALU REQUIREME <br />LC50 STATRE 96HR AC sAMPLE <br />PIMEPHALES MEASUREMI <br />TAN6C 1 0 U PERMIT. <br />EFFLUENT GROSS YALU REQUIREME <br />SAMPLE <br />MEASUREMI <br />~; .PERMIT <br />REOUIREME <br />SAMPLE <br />L: MEASUREMI <br />jayy i,~, <br />~ ' 1'.. )E ~~ (' ~,j z' ~ ~~ Form. ._ _` <br />NATIONAL FOLIUTMT deCNMOF ELIMINATION IYSfEM//N °Y~`,~;~ -OMEN 0'00~< ~~I <br />,_. <br />DISCHARGE MONITORINGfIEPOR_T/OM _-- - ~1"^~+-'~=i _~ ~ _ +°'~'~~~ .~µ ~+~v <br />u" (BURR DY) _~, <br />PERMIT NUMBER dxNMOE NIn.IeER p _ pINiL MESI ~ <br />MONITORING PERIOD ACUTE YET TEST-ROADSIDE POItiTS -~ <br />YEAR MO DAY YEAR MO DAY <br />FROM _ TO #¢4 NO DISCHARGE ~~~ #a# <br />NOTE: R~~d IInlTVetiofr Mlor. oompNUnO Thly Corm. <br />NT1TY OR LOADING QUALITY OR CONCENTRATION p, FREOUEN <br />of <br />- - MAXIMUM UNITS - MINIMUIGI - ~ -AVERAGE - MAXIMUM - ' -'UNITS EX fwayels TYPE <br />aaaaaa 7 ~ 00 ealaaaa a#a~aaa ( 23) ~ .~ 9a ~2 <br />#~~ SR- <br />> I O c7 <br />I ~ r <br />aaaaar ( 23) ~ / <br />8Q-: <br />1 . I ... , I _ ..,.I I- .. ~ . I. .... <br />I <br /> NAMERITLE PRINCIPAL EXECUEIVE OFFlCER """" """"'"'°"' "' °" "°' °""°"""""" ""`""`"°'^^ <br />vr.v.rta..a.. mr ah..nnn e...,.r.u..I..rte.e.~...lm . qn.n abp.a TELEPHONE DATE <br /> <br />~,F. S~OVlr la .wrt IL.1,u.MfMa pnenM,ropol [.rh...M ..W.Ie rh. In/.r~ll.n <br />..L..n.a. e..aon.rl,pm.Tadl. Frw. w,.r..r..n. rse.[. Ih. ry.fen. <br /> eE rhoR F.nw. M..cln rvpeidll. (R [.Iherlq Ih.lnf.r.ulb., IM Infemrrbn <br /> <br />Cf~~ ~ W Lmlll.a 14 1. Ihf Mll of m) LM.Ld[e .na L.M[f. lrve..nunlr..na tgnFl.le. <br />I.rt...rtu.rm.n.rt~[an...f E.n.lm r«renllnn <br />nbe lnrorvrlbn <br />AIONATL/NE OF MIINCwAL EXEClJf1VE ~O ~s- ~ a / b ~ O I Q <br /> TYPED OA PRWTED . <br />[ <br />In.f.db[IMV.~LIY1T Nn.e ..d lnq.Nennenl fx Lne.b[.1W.eoln OFFICER OR AUTHORRED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRd~r.nc. d iEEAahm.nh hrr4 <br />:,EE PART I. B.4 tOR DETAILS 0i TE5T PROCEDURE. RPT COYEST DILUTIOR (AEFFLUEtt) YRICB IS LETRAL TO-SOS OP <br />TEST ORGANIStlS (LC50) 8 ATTACH iCUTE TOY TEST RPT FOAM TO DMA. COPIES Ol ALL IYFO MOST BE 9S11T TO Epi. <br />EPA Form 3320-1 (Rev.3/99) Previauc editions maybe used. <br />0 0 0 01 / O Tl h i s C!~~ 4! ~3' 1 1 <br /> <br />