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PERMITTEE NAME/ADDRESS ~pncluJe Facility NamrlLaea(ion iJDifferenq <br />NAME <br />BLUE I`1(JUNTAIN ENERGY, iNC. <br />ADDRESSL~FSER ADC MINE <br />- :.607 COUNTY ROAD 8° <br />FACILITY P. I^.VGLY C~"! t3164F', <br />LOCATION <br />P.' l h JE"r F' DIJARERT <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM MFOES) <br />DISCHARGE MONITORING REPORT (OMR) <br />PERMIT NUMBER DISCHARGE NUM6ER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM OC 07 O 1 TO GC O "' .3 J. <br />MINOR <br />(SUltfi NW ) <br />F - F 7 NA:- <br />?P,--s LUADOVI <br />Form Approved. <br />OMB No. 2040-0004 <br />TO HE"D WASH <br />F?PI AN! <br />+fX-~ NU DTSL:HAFi>E IXI ~+'#+~` <br />NOTE: Read Instructions before completing this Corm. <br /> QUANTITY OR LOADING QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br /> EX OF TYPE <br />PARAMETER AVERAGE MAXIMUM ~ UNITS MINIMUM AVERAGE MAXIMUM UNITS ANA-t'S/S <br />H SAMPLE ###### ~##+t#,~ ###~-# r 1,~'l <br /> MEASUREMENT <br />G4 ;~._I 1 iJ i ~, f~'RM17`: - -"~I-:1LKMiI~IM,- - :+F,IR;id <br />f1b#: x#,r ~ <br />. ~.. - #iHF16~k ~.. 0 <br />~~~ <br />~-~ <br />F~'..'JENT Gi'USS '.'ALUE REQUI~6MBNL ~'• _ . <br />90L 'U5, TOTAL SAMPLE ###### ##+t### at#ir### c . , <br />U'...°cf~'iED MEASUREMENT <br />0: . `, I `JJ 0 -" 'P,ERNIIF '9k~FiF~k <br />„"Y 9h".~i'IEiFIb't~"'~ if#t' ~ ~~ ',!r -. O ~-/,, . Ali <br />•FT UENT. 6iROS5 VALUE ~REgUIREMENT _ <br />- ~ ~ ~. ##xt~ ODA AV6 DAILY- MX •!t`; I. <br />"OI..T!i5. SETTLEABLE SAMPLE +t#a### +r##### #t•#+t#a- .;'. ~ <br /> MEASUREMENT <br />0~•'5 1 ~ U O P~f3M)T" 'cilaF~Fl4~IF •.'1~' ,,.'_ #~ ~ ~~!'~' . ~; TLEf4"ORT REPORT :' A1~1~_ <br />FTLUENT GROSS VALUE REQLOPEMENT' #.a+r DA AVG DAILY MX h! ' <br />JIL iREASE SAMPLE ###iF~# n##### #####n #ors:_# <br /> MEASUREMENT <br />05~E: 1 U O • ~ PEF~MI'G '. .,"##k~'iA; #tt ;. I~•tt•AE~1.1F~F ~k#ir#ait 0 C, q$~ <br />_TF:UL=P!'( GRC56 'JALUE REQUIREMINT a~tar INaT A (' <br />LROM1:~ TRIAL. SAMPLE ###### #3#### ##tte;t# .." <br />(AS - FE) MEASUREMENT <br />lcu i c o }~r:RMIT" q~+a~~~wi I_ yr - ## +~s~~r- or •: o (a G~1` A~ <br />-FR UENT GROSFi VALUE REQUIREMENT- ; ~x ~t#u MX <br />-I_G~I: IN CONDUIT DR SAMPLE ( U3) #at#it## M#it##:r ,:#a~at; <br />f HRI--~ TPc.AT MEN~I PLANT MEASUREMENT <br />~-•005n I O O ~f'EAMIT "F;~ <br />~ #R ?F'- .~ ~...i-~V <br />_ °~~-~F~!#il~~. -. #~hiFiFikiF +F as <br />EyIL:Y <br />IV8TAN <br />FFL'.;ENT GRCSS VALUE REQUIREMENT . D ~ X GD _ oalr~ <br />lIL I;ND GREASE SAMPLE ####t+# ( 94) #+t#### #~###n #ila.pV <br />J :I 5~ .1L_ MEASUREMENT <br />40E~6 1 O 0 --:PEAIv11T_ -ht1FilM'1!#. .' _ • ;' <br />^ -S=1 ""Ii9F#~!li3F `-4HF9K#il•# ' i!-MY''IF+tdF iF :cat LY I <br />-FFL-UENT Gf+OSS VALUE REQUIREMENT - ENS7 <br />MA U=0 ### <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER ICeniy untler penalty of law that thls document antl all attachments were <br />repared untler m <br />tlireclion or supervision in acmrtlance wiN a system tlasignetl TELEPHONE DATE <br />__ r p <br />y <br />_ <br />~ES~ <br />7y L~~G <br />' to assure Ihat qualified personnel properly gather and evaluate the inlortretion , <br />~ <br />• j <br />! U submitted. 9ased on my Inquiry o1 the person or parsons wM marlage the system, / ~~ _ <br />' <br />r , or those persons duecUy responsible br gathering the information, the inbrmation - T'r~ I <br />;- i~G. ~_~~ submittetl is,tothe best of my knowletlge end belief,tme, accurate, antl wmplele. <br />enalties for submittin <br />false inbrmation <br />I am aware that Nera are si <br />nRCant SIGNATURE OF PRINCIPAL EXECUTIVE ?~ %ri -,~~iyL cc• r!,% <br /> <br />TYPED OI(PRINTED , <br />g <br />p <br />g <br />Inclutlin the ossibili olfne and lm risonmanl for knowin NolaLOns. OFFICER OR AUTHORIZED AGENT <br />NUMBER <br />YEAR <br />MQ <br />DAY <br />CQMMENTS AND FXHLANA I IUN OF ANY VIULA I IUNS (HererenCB all aRBCnmen[S here) <br />TSS ". TCTAL IRON LIMIiS WILL BE WAIVED AND SF.TTLEAIiLE SGLIDS LIMIT A'F'LLii; r';F' -? )YR..`~=Hft ?RECiF' [=Vc.Rll <br />Sir_E I A. 2., PG V. FOR REQUIREMENTS. 4TL. & GREASE P,EPORTING-SEF I.~B ] L. F'"; '.,'?r ,~,r,:; ~F,I•IF'LiNG <br />EP orm 0• ( 3 9) Previous a ilions may be used. THIS IS A 4-PART FORM PAGE OF <br />