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PERMITTEE NAME/ADDRESBpM~ifrmryNa./IacoIm VD11I,np - <br />NAME DOMUgR_HOHR COAL_ CORPARY --------_--_-_ <br />ADDRESS ROADSIDc ."!INF., N : S PORTALS _. <br />P.O. UJIf 130 <br />PALi~AD3 CO 41`,26 <br />FACILITY <br />LOCATION <br />. 1'[n: JUhh A. .1CNAP, P;cESIL °:;T <br />DISCMMOE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAV YEAR MO DAY <br />FROM VU lU TO UV 1 J <br />170-71/ III-231 13bI51 116271 118-I9I 130-311 <br />.. Forrtt Approved. ~. <br />F - FI t~AL <br />PINOR <br />NOTE: Reed irntructiorn belore completlnp thb form. <br />PARAMETER !3 Grd Ontyl QUANTITY OR LOADING It Grd OnlPl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE <br /> 106-531 151-ell 138-5 !4653 1Sb571 EX GF PE <br />l3I-371 MAirsls TY <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !ea-6.T1 !5{-5e1 /83701 <br />..::SU ~TAT66 4tl:i'~ AC SAMPLE .r0##'~ ##;#>:.y s:~###c CY;## ( 23) ~ ( <br /> <br />CidIODAPHNIA <br />MEASUREMENT <br />~~ <br />~ p <br />~9fl <br />~: ri:13}1 I U U ~ ~.PERMIT.. 7R#:i'al:`.# L"#sY. SAI'O~ r^. Sr'C I(t0 ~():Q.d'j. 10$rs##L ##'4#~~# . 'gR- '2~RLY ~ ;RAfS <br />FFLU3ii'l GROSS yRLU RE¢UIRENIEN7: :. ,. ##~# y.y. 1ALltE T <br />;, L:~Li STATkE 9fiHR AC SAMPLE :-:#r;=r ~Ia#c#~ #sql#>*# ~saaa~ <br />` 23) <br />( <br />k'iMSPHALES MEASUREMENT ~ 71b ~ ,~ qo R <br />iAaLC I U ~U ~ PERMIT.:~.~ <br />~ ~ I::~#u ,.P?~..:~.;: <br />~~ -: .~A1LT 41F!9!'~.4~. ~.~ Q#R ~,~I~V..a~~Q~:A.~ .~ .:..#?QI,RA~#1~~~~ ...:,. #aEE;o>a(#1(F;~;. BF~ ;`'~~1: ~. :T:BL~`:~ >'~.8 <br />;.FFLUENR t;R055 V0.LIJF REQUIREMENT~ ~..'~~ ...: ~~ ~ <br />~~ ~~~ <br />.., <br />-~~~~~~ ~ ~~ ~ ~ <br />s#aa <br />KN 1!AitbB ~. <br />:~: <br />;.: <br />~eilT ~ ~~ <br />: <br />, <br /> s. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ~ ~ ~ - ~ '. <br /> ~REQUIREMENT~ ~ - <br /> SAMPLE <br /> MEASUREMENT <br />~. <br />-.•~I PERMIT ~ - <br />~~ REQUIREMENT :/~;;,x" ~~ <br /> SAMPLE <br /> MEASUREMENT <br /> ... PERMIT .... .... .. <br />~ <br /> :REQUIREMENT ~,~ ~:. ~ `' ~ <br />~ ~~ <br /> SAMPLE _ -~ <br /> MEASUREMENT _ ~ - -- -~- <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ~ : <br />NAMERITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF U1W THAT I NAVE PERSONALLY EXAMINED µD <br />AM FAMILIM Nr1TH THE INFORMATION SUBMITTED HEREIN; µD BASED ON TELEPHONE DATE <br />I f~ <br />~, S+t~v~l MY INOUIRr OF THOSE INDIVIDUALS IMM WIATELr RESPONSIBLE FOR <br />OBTAINING THE INFORMATON, I BELIEVE THE SUBMITTED INFORMATION IS <br /> TRUE. ACCUMTE MO COMRETE. I AM AWME THAT THERE ME <br />SIGNIFICANT PENALTIES FOR SUBMITTING FKSE INFORMATION <br />INCLUDING <br /> , <br />T <br />1001 <br />T <br />T <br />F R <br />O <br />E 7~ t' <br />' <br />(( P.~ HE POSSIBILI <br />Y O <br />NE µD IMPRIS <br />NM <br />N <br />. SEE 18 U.S.C. E <br />µD 3J /810NATURE OF PRINCIPAL EXECUTIVE 1 <br />J <br />OR PRINTE D.S.C. E tJtY. IfYnAT4. utlr Trw mama wl.v Ncpd~ rw. w ro S 10,000 AREA <br />NUMBER <br />D <br />TYPED rrOwmtvMUn hrpirawwlr aFMnr.rremonee rgeFwa/ OFFlCER OR AUTHORIZED AGENT CODE YEAR MO DAV <br />} <br />1 <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Reference ell etrechmenb here/ <br />:t.fe PART I. H.4 -POE DETAILS OF TE5'P PROCEDURE'. RPT LOWEST DZLIJTION (;;EFPLLIEN'T) iIHICfI IS L5T.fiAL '.."G 'S,.°' OF <br />1eST ORGANI517S (LC SG) 6 ATTACH ACUTE TO%ICITY TEST !?E:POHT FORD TO DI7R. COPIES Cf ALL IhPO. HOST bt. r.t:T <br />.RNI TT c chat r rnE rr c e r rI rcR•T c nm c nr n .T rr n nTr r Tn mu ^..,~ T-• <br />EPA(Form 3320-1 108-961 Previous editions may be used. (REPLACES EPA FORM T~0 WHICH MAY NOT BE USED.) O U ? 9 8 / 9 B C 2 2 j - L 2 S b PA E <br />