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PERMITTEE NAME(ADDRESS pnr(ude Facdm~Name/Cncalion ifD$erenU NATIONAL
<br />NAME CUL'JaYO CUAL CUi`PANT, L. P. ~'^'~'~~~ I
<br />ADDRESS ~ -;~fF x-~~ ~~
<br />COLUHYO MINE ~ Nnn
<br />5731 STAT£ N.IGHNAY I9 'y~'`'
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<br />3E ELIMINATION:SYSTEM (NPDES) Form Approved.
<br />(RING REPORT `.(DMR~ ' OMB N0. 2040-0004
<br />' ~'-1'7` 9( ~5I ~'tJ )' APProval eXplres 05-37-98
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<br />(6b63) nNALYSIS
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER : I CERTIFY UNDER PENALTY OF LAW THAT I'HAVE PERSO
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<br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING
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