|
PERMITTEE NAME/ADDRESS (include FaediN Name/Location if Digerenll NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) Form Approved.
<br />NAME
<br />CCLU>:YO COAL CC!'PF. `:Y,
<br />L.i DISCHARGE MONITORING REPORT (OMR
<br />(z~ls~ 1+z~3si
<br />MI 40F OMB No. 2040-0004
<br />
<br />ADDRESSCO LO;YU r,INe
<br />canny ~tAi
<br />nnU 1 ~ ,
<br />~ Approval expires 05-31-96
<br />.~
<br />.O~/JI STATE, NTGR4AY 13 -PERMIT NUMBER
<br />_ ~
<br />~ DISCHARGE NUMBER P ~,. PI MAL ~ f40f A':
<br />'1F'ERF'.F. CO 81641 ~ GULCY A SEDI POVD/COOT Sere CR
<br />FACILITY
<br />LOCATION ~~''~`..Yc;,
<br />
<br />'
<br />FROM
<br />fi'.rt< FO ~ ~~
<br />Qt.t
<br />UISCHA'ic;".
<br />A T T R : J . D. H A R!f O N , G E N F: ° A I . " R. 'd .A ~~ !: p (zo z,l (zzfi~i~ :n(z - s < (zs-zr~ pa zs) (30-3f) NOTE: r~"~'
<br />Read fnshuctions befo compiehng this form.
<br /> (3 Cerd Onry) QUANTITY OR LOADING ~d~Cerd Onry) ~ .QUANTITY OR CONCENTRATION
<br />~ NO. FREOUENC SAMPLE ~~
<br />PARAMETER (46-53) (54-67) ,(46-531 (54-61)
<br />~' (3845) E% OF TYPE
<br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM~~ ~~ AVERAGE MAXIMUM UNITS
<br />(6z~1 aNALYSIs
<br />(64-661
<br />69-70)
<br />F'H SAMPLE QCa044 4ipSr4Ab' ~. 4'.e+}¢>'F+k ( 71)
<br /> MEASUREMENT r
<br />UU4UU 1 U U ~ PERMIT~v, ~r,~_ `k'•`-` ~a~
<br />-- ~'
<br />~ $fKLY LRSIT'.
<br />fFFLUF.`:II' ;;R.JSS YALIJc REQUIREMENT: 6 '~°? AQQt• ~ ;~' ,~/ .Iflil~f., Q11
<br />Si;LIDS, TO'iAL SAMPLE :kt=grs44 fi444~ ;QAQiIi{. -~ ( 19)
<br />:;!ISPF:FD'iL MEASUREMENT
<br />U01jU 1 U U .PERMIT ~
<br />k` r .~~ nt<# ~"~ "~
<br />At~r t°
<br />-E -
<br />~CEI~-
<br />iRA
<br />~
<br />FF'FLIIENT (Z';OtiS YALI~ ~REOUIREMENTs r-'r" ,'~`^
<br />,
<br />=
<br />~
<br />xT x"
<br />..: :' ~ r,r
<br />:4fA a 1N>~
<br />~
<br />~iY1L~~
<br />~
<br />i '!~
<br />/L ~ eL1MT
<br />k -
<br /> , ,
<br />t .
<br />_ti
<br />... ~ , .
<br />.
<br />r
<br />,~ .
<br />. -
<br />SCLLDS, S1:TTLF.ABLc: SAMPLE ~~`~~"" .-. „'`'` ~IROIRIt ( 24)
<br /> MEASUREMENT
<br />VUSVS 1 U G * PERMIT~'~' :, ,~'-v`.,y
<br />'
<br />°
<br />~ ~~` ,.
<br />~ brtrt _ , I~~,y ,~"' = C
<br />~ ~CE~-- iBAH
<br />EFFLUCNT GROSS YALUf ,REQUIREMENT t•
<br />~'"+
<br />s';;~ P
<br />,
<br />~ `
<br />""r+t:'k
<br />` "
<br />N$= r
<br />L/L
<br />1Id214F1-
<br />.
<br /> . *,
<br />. 3 ..
<br />INGN, TOTAL. SAMPLE °kn~:?>-F~ -er:nrt~w
<br />• ;:QQpgl>al
<br />( 19)
<br />(A r F (•) MEASUREMENT
<br />UlU4S 1 U U ~, ..
<br />'"PERMIT . .' 1410 ~+
<br />r- ~~10~>~ORP':'lI riII:Y <.t ' s ."~ # ;~":C lICS/. :8~'P.
<br />L'FFLUBvT GRO55 YALUc REQUIREMENT=
<br />
<br />v '°*' :,
<br />
<br />~ Q'k;Y ;~~-.
<br />
<br />~ ~ x
<br />~.'~ v
<br />.G/L
<br />lS~lt?R-
<br />OIL AND T;4FASF SAMPLE t:a'.~In-,rr .,,•,~.t-^:? ;i4;ti~4b ,' 444+6#• ( I~)
<br /> MEASUREMENT
<br />U J 5iT L 1 0 U
<br />F
<br />S'FI
<br />JF:NT i;ROSJ YALUf .'PERMIT . -
<br />FiEOUIREMENT~ IptG#~'~i
<br />~ `
<br />°' - rs!Gt44r#~ ~
<br />`".~ >?«,.
<br />n..,,^g ,~
<br />.~:~c :,~
<br />~ -
<br />A '"n(, ~: .r -,.
<br />,+.~
<br />G~-~,,~~.
<br />t:~~.. ::
<br />.
<br />. K .:s
<br />... :,. Q
<br />FLUG; IN CUNpTJ7T OA SAMPLE ( "J) ,"',"X.44 :~' ~P4i04:' #'~fi4d{: .
<br />
<br />T'~1 iFU TREAT'f ?fT PLAN'1
<br />MEASUREMENT .
<br />7UUSU 1 U O ~P.ERMIT ' < --' ~~~
<br />~
<br />-~r `: .~~~'~
<br />` ~ ~ 4'b4 ~; ~~$-~~F
<br />:: f'F'LU EtiT T;RO55 YALU' REQCIIREMENT' ~
<br />,y
<br />.: 3if~X ~'~
<br />~~" ,~
<br />7~
<br />SY
<br />(~~~
<br />'~~ "OP :
<br />' `~ `
<br />,~
<br />: 0>r'91tt ~ ~ fT
<br />* :
<br />x"'
<br />~
<br />-`
<br /> . Tt
<br />. ;
<br />:, ~y;v,~ „(4-:.
<br />. :
<br />, ~
<br />.u.-. v
<br />:
<br />~
<br />:,
<br />`;U l.I DS, '."IJT AL SAMPLE ;`r°^.'`rt:' '`^t"Y C_'t'~ `•=~'i4F4 ( 19)' .
<br />F;ISSOLY'::D MEASUREMENT -
<br />/ U 19 5 1 U 0 ~,.P,ERMIT vL ~~ _ ~ r 1Jf71lpFiAfQ~ 310 r ; ~~a ~4+# .w,~~y ,,,
<br />CFFLUf:KT iiROSS Y
<br />ALU REQUIREMENT` .;
<br />~;
<br />~ ~•.' '~ K, ~.y "' 3 e r• f ~i1-' ~ '
<br />.
<br />, ,
<br />, t
<br />NAME/TITLE PRINCIPAL E%ECUTR/E OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMILIAR WITH THE INFORM LAW THAT I HAVE PERSONALLY E%AMINED AND
<br />ATIO
<br />UBM
<br />TTED H
<br />RE
<br />AND BA
<br />ED
<br />~ TELEPHON
<br />/ E ' DATE
<br /> N S
<br />I
<br />IN;
<br />S
<br />E
<br />ON MY
<br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING '
<br />~~`
<br />i/
<br />/ /
<br />~
<br />~
<br />
<br />
<br />THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION I$ TRUE.
<br />`
<br />~
<br />WVF`^'V
<br />/ ~,~,~ ~/~~
<br />~
<br />l11tt
<br />' f
<br />~'~
<br />{{
<br /> ACCURATE ANO COMPLETE. 1 AM AWARE THAI THERE ARE SIGNIFICANT 1'
<br />~I
<br />~
<br />YY
<br />!~ ~
<br />~
<br />- PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING THE
<br />POSSIBILITY OF FINE AND IMPRISONMEM. SEE 1a U.S.C. 4 X001 AND 33 U.S.C .
<br />SIGNATURE OF PRINCIPAL E%ECUTIVE Q")i) 'Gr'7 •l1_I~."1 rl / Sr,
<br />
<br />TYPED OR PRINTED 4 1319. IPenetties uneer Inese srennes mey inclutle lines up ro Ef0.00o entl or
<br />mesimum impnsonmenl of heMeen6monMS entl Syears.l VIOFFICER OR AUTHORIZED AGENT AEA
<br />,
<br />'NUMBER
<br />YEAR
<br />MO
<br />DAY
<br />GUMMtN I S ANU tAPLANA I IUN UH ANY VIULA I IUNS (Rele2nae all a(hdahmen(S here) 1 ~' '
<br />SiT"'LF,A(1LF. SOLIDS LI"IT AFPLIF.S Ot:LY IF C=lUYh,2URR PR?CIP,,;$-:EMT IS CLAY*ED. IF ~>1PPROVt:D F.Y GI.CD,
<br />FSS f.^IkOR_LIRIT9 YLLL_NOT_yE APFLIcD TU REPOA.T_°D PF.ASURElfL1II5. - SEE. I.A. 2, if"~ •POF.BUP.Dw!i OF ?RQOF
<br />'~~' MONII TOFiING,PERIOD -
<br />YEAR MO. .DA Y,, ~~'; "YEAR MO DAY
<br />DO a41' ~ :TO 00 Q6 30
<br />erw roan ,fa~u-7,(ue:aa) Prewou5 saloons may not be usetl. - (REPLACES EPA FORM T-40 WHICH MAY:NOT~BE USEOJ. - ppOa9 / OO 0-RO J, ~i
<br />':.~TStLG6_'.~ti9Yi. .__i'-.-Lo-.+Yt:.,....~.- ....-_.. ~ _ we,--.G.~r~r''-. „_,. ..~ ~.. _~:+cn.pC :ti:rf ~,tt ~ ,. ...
<br />
|