Laserfiche WebLink
F4RMffTEE NAME/ADDRESS R.rAy FsWryxaw/L«olm lJDlf..mq <br />NAME SdNE:CA COAL COyPA.EY <br />ADDRESS D A 6 ii ~' ii D <br />HAYDdN <br />CO 81639 <br />FAaI-rrv <br />LocnnoNHAYuEN CO d153U <br />ATTR: G. 8DD B~UStN, GEAERAL MANAGER <br />NATIONAL POLLUTANT DISCHMOE ELIMINATION SYSTEM l/VPOfSI <br />DISCHARGE MONITORING REPORT IOMRI <br />17-151 17-19/ <br />COO JO a21 GCE A <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONIT RING PERIOD <br />YEAR M DAY YEAR MO DAY <br />FROM TO '' - - <br />l7P711 177-731 /11-751 176771 IIB-I9/ I3631I <br />Form Approved. <br />C T. ` C H A F G t: T O T S I 9OMBINo,12040/000~I <br />(5 D E A S d1) Approves ~ ~~ ~OS-31-98e <br />F - FIDAL ` <br />"T RCA <br />^~+~' NC DISCHAHGS ~__~ .. <br />NOTE: Reed inetruaiom before completing this form. <br />PARAMETER !3 Grd Onlvl QUANTITY OR LOADING Grd OnlYl GUANTITY OR CONCENTRATION NO FREQUENCY SAMPLE <br /> 146531 /5451/ 13BJ51 /065J 154511 EX / <br />V <br /> <br />I3I-371 MI <br />LL <br />SS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 167-e~1 154581 /59-701 <br />~(+ V , .. SAMPLE +1'A ~r''~•'•1'1 4917140 LL LA1f 0A0 <br />~~' <br />~ <br />~ ( I~) <br />~ <br />~ <br />GI~SOLYLU MEASUREMENT ~~ '~ ~„ <br />7U1'9S 1 U D PERMIT 91~>;+axa ...^•ao;~ aY9~ L+A~>Oki-R {F4xCNAi F.EFORT t D.LY .~-;A/' <br />F;FFLUflNT GROSS VALU REQUIREMENT '+xt=;: fi7F AYG CAFIY ?YR `!i: L <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <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 />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF lAW THAT I HAVE PERSONMLV E%AMINED AND <br />AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN <br />AND BASED ON TELEPHONE DATE <br /> ; <br />MY INQUIRY Of THOSE INDINDUALS IMMEDIATELY RESPONSIBLE FOR <br /> OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS <br /> TRUE, ACCUMTE MID COM0.ETE. I AM AWME THAT THERE ME <br />SIGNIFCANT PENKTIES FOR SUBMITTING fALSE INFORMATION <br />INCLWING <br />1 ~T/ C 1 <br />L <br /> , <br />THE POSSIBILITY OF RNE AND IMPWSONMENT. SEE 1B U.B.C. E 1001 AND 37 . <br />V <br />/(7 J1 ~ ~ <br />,i <br /> U.S.C. f 1]te. /P.m1aY1 udA• ewr moms meY MKJIdI rw.W ro flO,D00 BIONATURE OF Pail PAL EXECUTIVE <br />TYPED OR PRINTED .nswmuimen inpianwrr arMlw.«remA+N.rN eYW+I OFFICER OR A ORRED AGENT CODE NUMBER YEAR MO DAV <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Refrrence ell ettechments here) <br />'i5S LI!",iT HILL 8F' BAIYFU AND SETTLEABLE: SOLIU; LICiT i<P;LI°C ft5 <=1C1F,2UHR PP,P.CiP f.vF,r.T; 1", °, <br />3c'PTLEAbLS SOLIDS LIMIt NAIYED P0, >1DYR,24HR PRECIP F:YtN1' SUEJfC7 1C EURDEN CP PROOF IN I.A.2. OIT. L' <br />GNeA SP-SF. t' T. R.1.p. TDC Mn IITY(11?TN^.-c pr T.w-1-c. <br />EPA Fwm 3320.1 108-961 Previous editions mey bs uesd. (REPLACES EPA FORM TAO WNICN MAY NOT BE USED.) 00 G 8 9 ~ 9 7 ] 0 31-1513 PAGE lOF <br />