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PERMITTEE NAME/ADDRESS (include Fanliry Name/Locudon i/Dif/erenQ <br />NAME <br />DL-VE t`IOUNI-AIN f:N~RGY, INC <br />ADDRES~E5IFRADO MINE <br />3607 COUNTY ROAD 6S <br />FACILITYRAidGLY i;0 31h48 <br />LOCATION <br />n rr n,. rrcr n, Innvcr <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDESJ Form Approved. <br />DISCHARGE MONITORING REPORT (OMRJ OMB No. 2040-0004 <br /> M <br />(NOR <br /> . <br /> r eon- ~ t SUDR IVW i <br /> PERMIT NUMBER DISCHARGE NUMBER F - T T NAL F~ J i ,-1,~, <br /> <br /> MONITORING PERIOD 4A-1 L OADQ'.lT TCI R1:.I) L4ASH <br /> YEAR MO DAY YEAR MO DAY _ <br />FROM 00 OH O1 TO 00 08 R*a N^ DISCHARGE ! LCI #+~# <br /> NOTE: Read Instructions b efore completing 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 ANALYSis <br />-UL[FORt7. i-FC AL SAMPLE p-><+r'~r#+t ar zf a++#~ "?!'!-'-~a -;~% <br />=E-NE:RAL MEASUREMENT <br />'9C~:. 1 C• O PERMIT- *N4tiE#i-' ° lFap}4#"_ * x-?t lFifiFi}~HF Op0 000 # ' O L RAB <br />-Ff~LUEPJT GR055 VALUE "REQUIREMENT ~ #.x.~ ~ A [G')1 <br />)1L NI'JCi GREASE SAMPLE u####it q4! #pairik~[ a-tk><,%~'<~, nt~a:it;; <br />r~_~I F~; MEASUREMENT <br />-47f6 1 O O Pl;RMIF -' >~°~µy,*,* ~:;r~, -~~`~: S=1 '- ~F~U-,~,)It'Iw -:, I: itw#atirx iec~pil#iF # : •~a 47 ~t#,;,.Y -ISI/A~ <br />Ff-LUE'P;T GROSS VALUE REQUIREMENT 'I* O_O k•--G <br /> SAMPLE <br /> MEASUREMENT <br /> t- <br />,F <br /> REQUIREMENT ~ , <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> REQUIREMENT " -" <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT' <br /> REQUIREMENT ~ ~ ~ "" " <br /> SAMPLE <br /> MEASUREMENT <br /> ~ '~` ~~! k k '~ r. <br /> REQUI! A <br />EMENT ~ <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> REQUIREMENT .. <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER ICeNry under penalry of law thaz Nls dowment and ell enechm¢nts wore <br />i <br />i <br />ith <br />d <br />d <br />i <br />tl <br />~ TELEPHONE DATE <br />/ / <br />~ - OGF / <br />! V~ ~[~ ~: ~~ gne <br />n accor <br />ance w <br />es <br />prepared under my tlirecTion or supervis <br />on <br />a system <br />to assure Ihat qualifad personnel properly gather end evaluate Na inlonnehon <br />h <br />ih <br />t <br />i <br />f , <br />1 ~ ~' <br />~ `~ <br /> o manage <br />a sys <br />em, <br />subm.tted. Based on rmi kfqu <br />ry o <br />the parson or Permna w <br />A¢ mlonnazion <br />or those persons doeetly responsible br gathering Ne information i <br />~ ' - ° -~°'v'c <br /> <br />r , <br />c , <br />` <br />-,~ p 6 - C~.~ submined is , b the best of my knowledge ena IRlieq true, accurate, antl complete. SIGNATURE OF PRINCIPAL EXECUTIVE -T.' ii-Z ' U +=" <br />/ 7 '' <br /> <br />TYPE OR PRINTED I am aware that Nere are signifwnl penalties for submirong talsa inbrmetion, <br />indudm ma sibili oHine end ,m risonmern br knowin violations. OFFICER OR AUTHORIZED AGENT <br />E <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIULAI IONS (rieterence au attacnmen[s nereJ <br />~TL & GREASE REPORTING-SEE I D 1. F-, FG VI?niRiRLY Sril'1PL.INO iIVSTRIICTIONS-I. C. B. PG XI <br />EPA Form 3320-1 (RL-V 3/99) Previous editions may be used. THIS IS A 4PART FORM PAGE OF <br />00108/000222--1516 2 <br />