PERMITTEE NAME/ADDRESS (lnduJe Fanlin'Nome/Locution JOi$erenrl NATIONAL
<br />NAME f GLOaITJ COAL COf:FAYY, L.~. ~;,4x~;' _ I
<br />ADDRESS -;ti>;`~.'it+_,.
<br />C(:IL041Y0 f!INE rnn
<br />5111 STATE HZCHwAY Ii PE
<br />Mw'ggfrr Cr; t764I .
<br />PACIUTY
<br />LOCATION YEA
<br />FROM :Sys
<br />nTTN: J. D. HARROy, GEv°" AL ~•;,na.. •-~. ~~izo_:z
<br />TANT DISCHARGE ELIMINATION SYSTEM (NPDES) Form Approved.
<br />4R
<br />GE MONITORING REPORT (D
<br />MR; OMB ND. 2040-0004
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<br />e) HI;70k Approval expires 05-31-9$
<br />NUMBER ~~ _yDISCHARGE NUMBER F FINAL t4O F AT
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<br />MONjORIN_G'P,EBTOD' a
<br />aAdLHOUSF Sf:D7 TC TA710R C.P.?EP,
<br />AO ~, :+D.QV•, n YEAR MO DAY
<br />p#'~9i TO OD OE 30 ~'°'"= NO DI^_CHAN~E ~ ( ari°~
<br />I:P3 '. 1za zil ~ -'' rzss~J 12629) t3a9+1 NOTE: Read Instructions before completing this form.
<br /> (3 Cartl Ony) QUANTITY OR LOADING ~ (4 Card Ony)
<br />:QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br />PARAMETER (46-53) (54-61). ,
<br />(38-45) (46-53J (57-67/ EX OF TYPE
<br />(32-37J AVERAGE MAXIMUM, UNITS MINIMUM AVERAGE MAXIMUM UNITS
<br />16PE9) ANALYSIS
<br />(64.68)
<br />69-7Q
<br />F;i SAMPLE
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<br /> MEASUREMENT ~
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMILIAR WITH THE INFORM LAW THAT I HAVE PERSO
<br />ATION SUBMITTED HERE NALLY EJ(AMINED AND
<br />IN
<br />A
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<br />V
<br />~ TELEPHONE DATE
<br /> INQUIRY OF THOSE INONIDUAL
<br />THE INFORMATION
<br />I BELIEV ;
<br />ND BAS
<br />D ON M
<br />S IMMEDIATELY RESPONSIBLE FOR OBTAINING
<br />E THE SUBMITTED INFORM
<br />TION I$ TRUE ~
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<br />ACCURATE AND COMPLETE.
<br />PENALTIES FOR SUBMITTIN A
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<br />I AM AWARE THAT THERE ARE SIGNIFICANT
<br />G FALSE INFORMATION
<br />INCLUDING THE .t.
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<br />~ r ~ , , ~ ~ ,, ,, ~,,,, ~ POSSIBILITY OF FINE AND IMPR .
<br />ISONMENT. SEE t8 U.S C. § 1001 AND 33 U.S.C. r
<br />SIGNATURE OF PRINCIPAL EXECUTIVE Gl f) Q V - (....+ !n / ~n
<br /> § 1319. {Penetties untler these srelules may inclutle fines up ro ff0,000 sntl or `OFFICER OR AUTHORIZED AGENT
<br />
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<br />..,'.. „~ TYPED OR PRINTED mavimum,mpnsonmeM al beA,een6months end5yeersJ O NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Ae/erence all attachments het) ~.,. ,. ~ ' '
<br />Sf:TTLF.AEiLE SOLIDS LIi'ZT FFPLZF'S OSLY ZF C=.lOYP.,?4'NP PRECIF LYFNT I5 CLAI?'1ED. IP C' APPDOVEC PY 1~CD,
<br />T55 6 ZRON LIffITS PILL NOT HE APFLI~D TO 3Ei'CP.TcJ `!F4$UREMf: NT$ - S8E I, 1. 2, PG. SP.URDlrH OF Pk.COf
<br />.,~EBAFFOirn 9320;:1 (08A5),~Pre`vious editions~rriay not be used ~- ~ ` ~ ` (REPIACE$~PA FORMrT30 WHICH MAY. NOT BE USED'.).
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