|
PERMITTEE NAME/ADDRESS (include Faailirv Name/Lnmriun i~Di$erenr)
<br />NAME SLbi;CA COAL CCl'FAFY
<br />ADDRESSD k A Y E N, D
<br />NALDLrM
<br />CO B1E39
<br />FACILITY
<br />LOCATION N Y D £ M
<br />f>40; ~;e 1 f. 3 J
<br />AT"CN: G. 8UU BROYF, GEHEAAL lFi~A:,Fk
<br />NATIONAL POLLUTAN7 DISCHARGE ELIMINATION SYSTEM (NPDES)
<br />DISCHARGE MONITORING REPORT (OMR;
<br />a-ls~ (n~ sJ
<br />C00 '0 1 003
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEA ~ DAY YEAR MO DAY
<br />FROM TO ~
<br />(20-21) ~ "' f24~P/J (262JJ (2929) (3031)
<br />Form Approved.
<br />R I ti 0 k OMB No. 2040-00
<br />Approval expires 0 8
<br />(SUBA !fi)
<br />F - FIYAI U2T
<br />DISCkAf,G£ 7C G6A~SY CFE£F
<br />NOTE: Read Instructions before completing this form.
<br /> (3 Certl Only) QUANTITY OR LOADING (4 Card Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br />PARAMETER (46-53) (54-67) .(38-45) (46-53) (54-srJ EX OF TYPE
<br />(3237) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
<br />/s2 b37 ANALYS75
<br />(s4-68)
<br />69-70
<br /> SAMPLE 4-. -A t: 04444
<br />C ( li) ) /'
<br /> MEASUREMENT Z 1 i~
<br /> • • /
<br />UU40U L U l:
<br />' 0EF3fY11Y'
<br />~
<br />"~ 4'
<br />~ Yr,~ ~y..
<br />'
<br />' '~
<br />E >i !'
<br />NS32U
<br />EF
<br />FLUYNT GHOSS YAIUE ,A~2~UIREMEN7
<br />.. ~^-~ T
<br />,~- "-'`
<br />~ xOr,M tlxMYaD ,T ,;',.. ~~ ~:.~.~ SU
<br />50 DS, O A
<br />SUSFENU60 SAMPLE
<br />MEASUREMENT S4G 4#4
<br />0 44440#
<br />' ~ ( 15)
<br />O
<br />~/ v
<br />
<br />CS3U 1 U 0 ~-,;pEEMEr-; z4r ~ :•~s „ qGE) -Ail
<br />tF't'LU(;!12 GR055 YALGE r33~~lIIt3pM~J>t`f "'
<br />~ Xy4 r;l yfQ`",~ '~",~" 1l<p eGi I ~~_ ittl
<br />".
<br />" l%" .>,, c L Ef SAMPLE ;:4401 .' ~ 4:+,:--^.4 ~}:;0 ( i ~)
<br /> MEASUREMENT ''~
<br />l ~~ o o Z ' ~• d
<br /> u a
<br />ti ~~4 S 1 0 0 PEWi4Yl'C". ~ .. # # X 4'~ 0 ~
<br />~~ E E" .
<br />EFF'LULNT GkUSS YALUt 41~QlJIfSE(~1~°Nt ~4.^. ~
<br />"
<br />~
<br />,.
<br />. "
<br />1 !SVY, UTA SAMPLE 444 ,r,>;: r~04044 44440.'1 O
<br />a S D
<br />~ S ( ]5) I /
<br />(AS FE) MEASUREMENT ~ • • D U w
<br />lU4S 1 U U A~~~~. iiil # XL: 0##
<br />~ A(,~/. 'FAEI "
<br />EFFLUENT GROSS YALUE RE$tUI~Tv9~~T~ }
<br />: ~'+; ~-.'- ~. c>r~. ~Q~~ ~'= 1AG/L ~ 14N
<br />7h
<br /> ~, ,
<br />liL AH ; Ck A SAMPLE 0"0 "' 4 ~04Yi~0 00# ( JS)
<br /> MEASUREMENT U
<br />
<br />£PFLUEt~T GROSS YALUE tit=~1~liR~IVIEPY~'~ y is4:: ~ ~ ~ ;; AQ~
<br />L gyp;
<br />! ..L~19 ` "
<br /> ~ ~ ,
<br />t~' / ,
<br />,
<br />FLu4, 16 CONDUIT Ui
<br />' SAMPLE '1
<br />/~L 1 3) 000400 40 '4 0 0440 ' i
<br />I
<br />HkU Tr'tAT~ERT PLA111 MEASUREMENT 1
<br />O ~ O ~5
<br /> T/,V ,
<br />SUUSU 1 U 0 ~ ~ :; 0# #. ~.,;' 1 '>i 9 441 ~ ~.>y $~,
<br />E P F L U E ~'f G k U 5 5 Y A L L E l~7cQ.U1M~7T ;=90~a:-a~!G! },
<br />'~ ~ - ` - !E~-, E C D ,
<br />. ~ ~ ,, " " ~ "`.. " ~~,•, ~ 4 4 ~ A .. ~. ~ - "~ •
<br />5CLiDS, 1"UTAL
<br />U SAMPLE '~#~'~ ~ ~+~~=~ 4#4x44 ~~` ~ ( 1') ~
<br />
<br />I::SOLY EC
<br />MEASUREMENT ~ v
<br /> ~
<br />/Od9S 1 U C ~ `~8RMf7'. = ~~ ,.
<br />" Ito: >• ~ $ Jt_Ct
<br />~ ~ 7 IAE~..
<br />eF:'LU£h T c,k055 YALU£ fi ~11F7EM(x~t~ ', ~'~ ~ ~~ .` 4444 ~ ~~Q." d#II~ ~' ~ EC/i
<br /> .y
<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF L
<br />AM FAMILIAR WITH THE INFORM AW THAT I HAVE PERSONALLY ExAMINED AND
<br />ATION SUBMITTED HEREIN
<br />AND B45ED ON MY TELEPHONE DATE
<br /> INQUIRY OF THOSE INDIVIDUAL ;
<br />S IMMEDIATELY RESPONSIBLE FOR OBTAINING
<br /> THE INFORMATION, I BELIEV E THE SUBMITTED INFORMATION IS TRUE,
<br /> ACCURATE AND COMPLETE.
<br />PENALTIES FOR SUBMITTING I AM AWARE THAT THERE ARE SIGNIFICAM
<br />FALSE
<br />NFORMAT
<br />ON
<br />INCLUD
<br />NG T
<br />E 1
<br /> I
<br />I
<br />.
<br />I
<br />H
<br />POSSIBILITY OF FINE AND IMPRISONMENT. SEE 7B U.S.C. 4 1001 AND 33 U.S.C. SIGNATURE OF P
<br />ICIPAL EXECUTIVE
<br /> 4 1319. IPenatt~es under Naze srerures meY inclutle lines up ro 570,000 entl or ~
<br />
<br />TYPED OR PRINTED
<br />maximum impdspnmem ol6ehveen6months and5yeers.) OFFICER OR A HORIZED AGENT
<br />~O
<br />NUMBER
<br />YEAR
<br />MO
<br />DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Aeterence all attachments here)
<br />'CAS 6 1tiUN LItlIT5 TILL L!2 YAIYEU E SETTLEAeIE SGLJCS LIi!I1 AFFLI£D FC'A <=l0YN,24EE FRECJF EYE13; 1°5,
<br />IkU9 G St:TTLEABLE SLLIOS LIAITS YAIYED POP, ~lOYA,i4NA FAL'CIF EYENT SUFJECT TC kUFCFN CF FACGE I{ I.A.2.
<br />r~T !' i CC r.n 7n i
<br />EPA Form 3320-1 (OB-95) Previous editions may not be used. (. PWCES EPA FORM T-40 WHICH MAY NOT BE USED.). ~. ~enws'a ino r c , ~ _ ~ c e e GAGE ~ OF
<br />
|