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.~ 4i <br />PERMITTEE NAME/ADDRESS (lnrlude Fauerv NomdLorarinn JDrgerenrl <br />NAME SEMECA COAL CCF'FAFY <br />ADDRESSD3~YER D <br />NAYDEM CO tllr3t <br />FACILITY . <br />LOCATIOt~A YDEN ~ ~ CC 61630 FROM <br />AT:h: G. bU0,B80giI, G#L MlMAGEN <br />ITANT DISCHARGE ELIMINATION SYSTEM (NPDES) Form Approved .°~1Mr <br />AR GE MONITORING REPORT .(pMA;9j r L ~C P OMB ND. 2040.0004 <br />Approval expires OS-31-98 <br />I21 .@17 (SUBS MY) <br />NUMBER DISCHARGE NUMBER f -' F L ti A[ Fj0 U T T <br />MONITORING PERIOD LL SC Y.AECF TC BU FEEt.SCII GU1Cfi <br />O D Y '~` YEAR MO DAY <br />- ''"gyp uu '_~ J1 ~#~° AC [1SCNAFCF ~--~ >DOQ <br />?~z3) ~. (z . (zs~zn !PB-29J (3P31) NOTE: Read Instructions befo a completing this form. <br /> (3;Cerd Ony) QUANTITY OR LOADING 2rtl Only) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER " (46-53) 154-87) (3s-45) (46-53) (54-61) EX OF TYPE <br />(32-37) <br />.;=RAGE <br />MAXIMUM <br />UNIT <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS <br />sz ril ANALYSIS <br />(s4-ss) ' <br />69-70 <br /> ~i,- I <br />) <br />~Hr' SAMPLE 1 'JU) 9+7A ~ L L' <br />Y I S U A L MEASUREMENT ~ <br />~ <br />tl406o i U U ~ PERtaITT~ x;. :" ES=1 ~ N -, '- ~t0 <br />~ /, <br />EFFLUENT GHO55 VALUE i~p <br />~LyIQEfdENT - <br />`~' ~x~ IC=U ~ <br />~" TM <br />+°~ <br />: _'~ ti~ <br />~ OAIOC '~ ~~ ; <br />"=' <br />' <br /> -, . _ ~ <br />.. <br />. I " <br />, <br /> SAMPLE <br /> MEASUREMENT <br /> ~~Rbl1T <br />~i3UIR~ ENT ~; :;~: ~$tra ix <br />' <br />~ by + -- <br /> B ~ ~- <br />a~ ~ >~^"'~ <br />n.5 <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> :. <br /> SAMPLE <br /> MEASUREMENT <br /> _ <br />" ~~~~ <br /> E ENT <br />-9EON1IF3 ~ ~, w " "S r Ja ' .- <br /> SAMPLE <br />. MEASUREMENT <br /> <br />- <br />' <br />~ <br />~ ° s--~.- y. <br />'~ <br />- <br /> -AE <br />. <br />ENT <br />ISIR~ ~+.7 <br /> SAMPLE <br /> MEASUREMENT <br /> . ,~; PERM, k ..e ~~.. <br />r z <br />~ - - - I <br />~~ K rr <br />~ <br /> <br />AEd~71AE ~Ni <br />~ <br />~° . i <br />: <br />' . <br />"! <br /> _ti <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> I <br />s: :i. <br /> AE ~II~ EN7 ':: <br /> ~ rt, ~ ~ <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER CERTIFY UNDER PENALTY OF LAW THAT I HAVE <br />PERSO <br />ERE NALLY EYAMINED AND <br />D BASED O <br />MV TELEPHDN ~ DATE <br /> AM FAMILIAR WITH THE INFORMATION SUBMITTED H <br />IN: AN <br />N <br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING <br /> THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS TRUE. <br /> <br />" ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT I <br />~ <br /> PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING THE 0 / \ D( / <br /> POSSIBILITY OF FINE AND IMPRISONMENT. SEE 19 U.S.C. § 1001 AND 33 U.S.C. SIGNATURE OF PRINCIPAII..~~EXECUTIVE C./ ~/ <br /> <br />TYPED OR PRINTED § 13r9 (Penalties antler IAaze 51Blules mey inclutle lines up to EI0,000 entl or <br />maximum lmpnsanmenl of beMeenBmwrths entl 5years.) OFFICER OR AUTHORIZf_D AGENT <br />NUMBER <br />YEAR <br />MO <br />D Y <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Rererence all attecnmenls Here) <br />TS;S t: 1JJOtl LIF7iT5 AIL? 8E YAIYED E SETTLEAHLE SCL7D5 LItlIT AkPLIEG FON <=l0YF,24ffi FFEClj E~EY1; 1SS G <br />IhpN LIMITS MANED FCF ~l0YN,24NN PaECIP EYFIiT SUEJECT TO tlUBDFN OF FFCCP IN I.A.7. CII d GEEASE - SEE <br />r r._'I-n enc wn+ur+~crr:r• _ r u-~Ic __ <br />EPA Fcrm 3320.9 (OB-95) Previous editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY NOT 8E USED.) 0019.5) 9 9 C E 2 7 -1 b 5 3 PAGE 2 OF <br />