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PERMITTEE NAME/ADDRESS (lrii4. FrwryNadlncmlm dDdrl..,.B <br />NAME `-iENh; I:A COAL (: :;r;, r•Ir <br />ADDRESS I/:L A rI E FI U <br />FIAYGE:N <br />CO Hi53~ <br />FAaLm <br />LocAT1DN FI A Y D E N CO 816 3 0 <br />A.Tfb: G. bUD BkO1N, GPVERIL KlNMGER <br />NATIONN. POLLUTANT DISCHA110E EIJMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT IOMRI <br />I7-161 I7-191 <br />000000221 COf A <br />PERMIT NUMBER DISCHANGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM ~ L TO l.] .l <br />!2611/ 111-131 I 51 116-17/ 119-191'134311 <br />Formp,Approved. <br />f T .` C H A F .~ ~ T 7 " a i p~-yNyH2O~ OQ04 <br />(5 U E A [~ J ~ ApprovelLexp~r$ ~OS-31-9= <br />P - FI?AL [ ` <br />rr>,cR <br />'~~- AC CISC!'A?GE ~__~ ~~~~ <br />NOTE: Raed inewctioro before completing Thu Corm. <br />PARAMETER !3 Grd Ontyl QUANTITY OR LOADING ,. (4 Grd Ontyl QUANTITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br /> 146531 !54-61 /3B-451 146-53 154-611 GF <br />131-371 EX <br />YAS <br />ANN TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS Is1-sm - <br />I6q-6g1 169-701 <br />W, h CONDC; I'!' ~)f? <br />f <br />- <br />' <br />' SAMPLE <br />MEASUREMENT <br />C• <br />' ' <br />L ~_~ ~ <br />~~ ( .J3) L~Oan>?4 pxy,::~tr r: ryf,^;::~~: <br />O '/ <br />H 8 U 1 <br />d :, A <br />f M E'I T I <br />L 1 '; . <br />O <br />SG~,)SJ 1 U C PERMIT R~'PO&T OPTIOtR~Y.."; 4O71ib10....:' <br />.~ fiACgIF4 ra+.t::tY <br />~ r <br />~E'Y~.,Y r' <br />i?ISTn~ <br />EFFLUi:NT :;ROSS VALU .REQUIREMENT 30UA Ay;, DAI.LT !!Y' lIGD <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~':~ " <br />~ <br />~ <br />~ ~ <br />~ ~~ <br /> :REQUIREMENT ~ <br />' <br />/~~~ <br />~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ' <br /> REQUIREMENT <br />~ <br />NAMERITLE PRINCIPAL EXECUTNE OFFICER I cERTIFr UNDER PENALTV <br />oF LAw THAT I NAVE PERSOSULY ExAMINEO AND <br />AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN; AND BASED ON TELEPHONE DATE <br /> MY INQUIRY OF THOSE INDINDUAL9 IMMEDIATELY RESPONSIBLE FOR <br /> OBTNNINO THE INFORMATION, 1 BELIEVE THE SUBMITTED INFORMATION 19 <br /> TRUE, ACCURATE AND CAM0.ETE. 1 NA AWME THAT THERE ME <br />SIONIRCANT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INCLUDING <br /> , <br />THE POSSIBILITY OF RNE AND IMPWSONMENT. SEE 18 U.S.C. E 1001 AND 3] 610N <br />TLI <br />E O <br />P111N AL EXECUTNE <br /> U.S.C. ! 131 e. lAYIrItlA, „~.. FMar AhM.A neY M[FNA fws W ro F /O.000 A <br />R <br />F <br />TYPED OR PRINTED rwa-nMAilwn h,P+onwnr Prbe...ASA.met.w sY..ra/ OFFICER OR A RIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Reference sll sttschmenrs here) <br />T55 LI9IT 'uILI rIE uAIVi:; AhD SETTLEAEILE SOLIDS LZtII'f .RPi-LIEC FCF <=?C F,2/:iH GFECIP EVE:bT; TSS i. <br />SETTLEABLE 50LIUS LI"!'. aAIYcD FOR >lOTP.,2U6tt PkECIP EVEN: SU'JFCT TC FUFUEN CF P'OOF IN I.A.Z. UIL F. <br />h$F.a SF.-GYR T. R.1p. T':IC Mr14 TTflq TN^.GPF 7~p-7-F- <br />EPA Form 3920-i LOS-S5) Previous editions mey be used. (REPLACES EPA FORM T-00 WHICH MAY NOT BE USED.1 ~ o a s a i s ~ 10 31-1 s 1 ~ PAGE IOF <br />