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PERMITTEE NAME/ADDRESS pnclude Facility A'nme/Lncarion JDiffe.enQ
<br />NAME CULOwYO COAL COitPAA'Y, L.t:.
<br />ADDRESSCO L C~ Y Y C t1 I N E
<br />57.11 STATE HIGHYAY 13
<br />nF,£tt£a co elbul
<br />FACILITY
<br />LOCATION
<br />A'PI'N:. J. U. HAt"~ti, GFNFF'AL M61'AGhS
<br />DISCHARGE ELIMINATION SYSTEM (NPOES)
<br />MONITORING REPORT /DMRI
<br />~w•PERIv11T NUMBER I I DISCHAf1GE'NlllA9ER
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<br />°~'~ MONITORING PERIOD'' ~~
<br />FROM 11')~ UIV
<br />(20-2/) (22-23)
<br />(z6-2B1 goat)
<br />Form Approved.
<br />OMB No. 2040-0004
<br />~I N U u Approval expires 05-31-98
<br />(SUIIR HR)
<br />F - FIItAL ROFA7
<br />LOAD011T SF.DI POLED TO MTL50N CH
<br />~~~= ,tl0 DISC!!AHGo ~ -~ r%r.,rl
<br />NOTE: Read Instructions befor completing this }orm.
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<br />PARAMETER (3 Cerd Only) QUANTITY OR LOADING
<br />(46-53) (54-67) „;~ 4 Gerd'Ony) QUANTITY OR CONCENTRATION
<br />~I '(38-45) (4G53) (5467) NO.
<br />EX FREOUENC
<br />OF SAMPLE
<br />TYPE
<br />' (32-37) AVERAGE MAXIMUM UNITS ~ MINIMUM .AVERAGE MAXIMUM UNITS
<br />(6263) ANALYSIS
<br />(64-68) I
<br />69-70
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<br />NAMElTITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EYAMINED ANO
<br />AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN
<br />AND BASED ON MY I ///```n
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<br />\ / TELEPHONE' DATE
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<br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING j
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<br />THE INFORMATION. 1 BELIEVE THE SUBMITTED INFORMATION IS TRUE,
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<br /> ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICAM
<br />PENALTIES FOR SUBMITTING FALSE INFORMATION
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<br />lln ~x I„r ,~ POSSIBILITY OF FINE AND IMPRISONMENT. SEE to U.S.C. § 1001 AND 33 U S.C. SIGNATURE OF PRINCIPAL EXECUTIVE 7~ Il OT EJ~i r_ .~ n /T r 7 /.. •~..1
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re/erence all attachments here)
<br />SFT'fLt:4PL£ SULIUS LICIT AFPLT£S UNLY IF <=1QYF,,7.4HA PHECIf? P.;ANT IS CLAI'1£U. IF CLAjIEI' ~PPROYF.L` NY 4QC'L!,
<br />T35 E; INON LIMITS RILL kOT B£ APPL1cD TO HEPORT£D `!EA4~6w~NT5 - SEE I.A. 2, PG..~~ ;~BflAD6&'OP Pk00f'
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