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<br />NAME CYYHUS YA!1PA YALLF'Y COAL COHF.
<br />ADDRESS`IhF: 1, 2Ej SOU'C 4, L EC h:rAei L'F;
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<br />FACILITY
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<br />DISCRARGE MONITORING REPORT (OMR;
<br />(216) (n- Bl
<br />000027154 003 e
<br />PERMIT NUMBER DISCHARGE NUMBER
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<br />YEAR MO DAY YEAR MO DAY
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<br />(2621) (PA231 f24~25) (2&2]7 (2829) 13031)
<br />Form Approved.
<br />"A ~ U ft OMB No. 2040-0004
<br />' Approval expires 05-31-913
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY E%AMINED AND
<br />AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN; AND BASED ON MV TELEPHONE DATE
<br />Rlcha rd Mi 11 s INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING
<br />THE INFORMATION. I BELIEVE THE SUBMITTED INFORMATION IS TRUE,
<br />Environmental Mana er
<br />9 ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT
<br />THE
<br />T ~ 97G-S70-2712 ~'
<br /> PENALTIES FOR SUBMITTING FALSE INFORMA
<br />ION, INCLUDING
<br />POSSIBILITY OF FINE AND IMPRISONMEM SEE 1B U S C § I W1 AND 33 U.S.C.
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<br />SIGNATURE OF PRINCIPAL EXECUTIVE ~ 7
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<br />NUMBER
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<br />COMMENTS AND IXPLANATION OF ANY VIOLATIONS (Relerence all attachments here)
<br />AL'PERNn'ft LICI25 FOk TSS, IRON ~ SE'ITL~APLF SOL?US (LOC '0') APPLY URLY IF <= 11;-Yi, ~4-IG PBiCIP :VENT
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<br />EFA Form`332o-1 (OB-95) Previous editions may not be used. (REPLACES EPA FORM T-00 WHICH MAY NOT BE USED.) O V .t 3 1 /') O ' 4 U S-1 5 O ~ PAGE I OF
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