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PERMITTEE NAME/ADDRESS (lnelede Facillry Nmne/facarion ifA'ffamt) .NATIONAL POLLUTANT DISCHARGE ELIMINATION SvSTEM (NPDES) FORM Approved. <br />NAME DISCHARGE MONITORING REPORT (DMA) OMB No. 2040-0004 <br />ADDRES~LIIE MOUNTAIN ENERGY, INC. MINUR <br />DESERADU MINE pE Nt4 ER DI GE UMBER (SUIiR N41) <br />3:,07 CDUNTY ROAD 55 F - FINAL- F!L'I_r'+~V <br />FACILITY RANGLY CO 51648 MONITORING PERIOD ACUTE WET TES'TIIVG 'r OR OG4 <br />LOCATION YEAR MO DAY YEAR MO DAY <br />FROM ,-, . „ „, TO ,~ . ~ nI'] (f'~ ~~1Ipppp FF ~~ sF <br />- - ~~ '~#I~O~~Reat7 InsiruCtion~6efore'EorriDle[In0 this form. <br /> QUANTITY OR LOADING QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br /> EX OF TYPE <br />PARAMETER AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS aNaLYSG <br />CSC STATRE 48HR AC SAMPLE ###### ###### tt##ttr.# #tt-+?+tta ~ c:i; <br /> MEASUREMENT <br />CER.TODAPHNIA <br />T <br />? <br /> <br />### <br />°-"' ~- <br /> <br />ik <br />"? ~~ ,,,„, d <br /> <br />ik# ~ <br />~ <br /> <br />ER- <br />' <br />AM:; 13 1 C <br />O , 'F _,, <br />,_. <br />' ~; <br /> ~~ T ~~ ?~ . ,a <br />LC?G ~'fATRE 96HR Ai: *'##### ###it## #x~xtr+ta fink#~# ( c_i: <br /> MEASUREMENT <br />P1ML"PHALFS <br />TANL+C 1 O 0 ### :i~'J"~ ~' ~iFOF il~M#Alfl~ ,..: c_I' ~~ y~:, <br /> , <br />r~d _ <br />I <br /> <br />- r 3 <br />. _ .~. ~. ... SAMPLE _ . <br />SAMPLE <br />SAMPLE <br />,'. SAMPLE <br />MEASUREMENT <br /> <br /> <br />SAMPLE <br />_ MEASUREMENT <br />_.. ~ ~ ~, .' k'. ~ ~ , ~ :~. <br />NAME/TITLE PRINCIPAL EXECUTVE OFFICER ICertfly under penalty or law tlrol mis doNmem end ell atbchmrmb were TELEPHONE YDATE <br />prepared antler my tlkeNOn or errpeMSlon kt ermrdance with a system designed <br />b assure Ural qualified personnel property gather end erwuaze the hdemutlon <br />S~ q7J' (L~w..,d ~~ eubmltletl. BaseO on my Inquiry N me person or persons who merege the system, / y <br />or tlbse pareons directly responsible br gathering the inbmoaon, the Irdomutlon ~ ~ <br />submitted b , b the best of my Imowledge end beliel, we, emirate, eM complete. SIGNATURE OF PRINCIPAL EXECUTIVE 7 i (': G <br />l em aware thattMre erv slgnlfirart peroNav larsWmating raLSa lrrbrmetlon, OFFICER OR AUTHORQED AGENT <br />TYPEDfbft PRINTED Inclutlin Ne ssiblli of fine end rbonmorrt brkrowi Woleaons. NUMB R YEAR MO DAY <br />r~......r-uro nun CYUI Ar.IATI(~rJ flC aLN \llhl ATI(1rJC /Onfmm~nc nil aNarhmnnb Aaml <br />SEE PART I. B. 3. PG VIII. FOR DETAILS OF TEST PROCEDURE REPORT LC 5U - STATISTICAL. PLIIIII- ESTIMATE WI1I :H <br />I:S LETHAL TO 50% OF-TEST ORGANISMS. AND ATTACH ACVTE TOXICITY TEST REPDRT FDRM TC1 OMR. COPIES DF ALL <br />ERpiF5ffl1'3526~7 QRfVR~lbSjTPrSi6usSaai111rTs rr~Ibr~TISs9~1. THIS IS A 4PART FORM PAGE OF <br />OO11HiG00222-1516 1 <br />