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PERMITTEE NAME/ADDRESS (Gd:e. FxYlyNw./locmlm UDl~,.rrJ <br />NAME :iGi1pL:A COAL COMPR\Y <br />ADDRESS DnAJEF? D <br />HAYDEN <br />CO e1639 <br />FACILITY <br />LOCATION N A C D t t~ CO 816 3 0 <br />ATTN: G. JUDdRU4N, ExNCY.AL P;AtiAGi:'R <br />NATIONAL POLLUTANT DISCNMOE ELIMINATION SYSTEM (NPDESI <br />DISCHARGE MONEFORINO REPORT (OMRI <br />IZJ 61 l17-191 <br />COGODU221 C11 A <br />PERMIT NUMBER olscHMGE NUMBDI <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM~yO w ul TO yn <br />%16111 !IZ-131 !10.151 116-171 /15-191 13631/ <br />Form Approvetl. < <br />`_°C• FCNC D:iCGI? 10MB~No~204t}0004K~b. <br />(S U E A ~ W) ApprovelLeXp~ ~ ~OS-31 9$Y- <br />F - FILIAL %~ <br />T+IFCA <br />fi ~`fi T;C DISC:IAR,E ~~ °=fi~ <br />NOTE: Read inetructlone bsiws omptstlnp tlue 1wm. <br />PARAMETER l3 Grd Onhl QUANTTY OR~LOADING ~ II Grd Onhl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE <br />l31-37/ /46-53/ /5~-6ll~.i 135-<51 /<6-53 /54-511 Ex GF TYPE <br /> <br />AVERAGE MAXIMU#M~.NITS <br />MINIMUM AVERAGE MAXIMUM UNITS <br />!u-sal MALYSIS <br />/64681 <br />159-701 <br />UlL ANU li lS F'.45E SAMPLE :~St r;:7 ) 4fi'J~OA ',1 L'CxJ s?fi .C#:;F# <br />Y I :i J A L MEASUREMENT 7 <br /> <br />buUbU 1 U G PERMIT ~.~:~~.5: AdFU$T `. F:S=1 ::.xi.Y,.4:J~ x3 :: ,; :Y. '? Y.xi+'.Y:=`.'s . . <br />iF.rtikLY <br />VI5I:AI <br />tFFLJENT 1:A055 V,4LG1 REQUIREMENT' L`7riI ?SAX NC=O r+'''•:' <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 /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> <br />NAME?RLE PRINCIPAL EXECUTNE OFFICER I CERTI <br />AM FA FY UNDER PENALTY OF L <br />MILIM WITH THE INFO AW THAT I NAVE PERSONALLY E%AMINED MD <br />RMATION S <br />BMITTED NEREIN <br />MD BASED ~ TELEPHONE DATE <br /> ; <br />U <br />ON <br />MY INQUIRY OF TNOSE INDINDUALS IMMEDIATELY RESPONSIBLE fOR + <br /> OBTNNINO THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION 15 <br /> TRUE, ACCUMTE MO COMPLETE. I AM AWME THAT THERE ME <br /> SIONIFICMT PENALTES FOR SUBMITTING FALSE INFORMATION <br />INCLUDING <br />. , <br />THE POSSIBILITY OF RNE MD IMPNSONMENT. SEE to U.S.L. 1 1001 MD 3l 610NATURE OF PRI /PAL EXECUTNE <br /> U.S.C. ! 13te. lhrrls, uMr IMr mlvr„ nvY 41cFA, Fxlr, to ro EIO,OOD <br />~ AREA <br />TYPED OR PRINTED rtl rnrY~E,:f.l,a.,wraan..«,snlmm,wsr.,r.l OFFICER OR AUE <br />10pRED A0EN7 ~E NUMBER YEAR MO DAY <br />GOMMGN75 ANU tA.YLANATION OF ANT VIOLATIONS lRe/eF~nce e// sfrechmsnrs here/ <br />i5i E IAOR LICITS SILL yh WAIVED dYD SETTLF.A~LE SOLIDS LIYIY +FFLI?C FC9 <=70YR,21Ji'A PRECLP EVENT; T5~ E <br />/ROY LIHITS 'aAIVF.D FOF >1CYH,2dAA P,tECIP EVENT SU8,7ECT TD BUFCEt~' CP FFCGF IM I.l.2• OIL E GREASE'-SEE <br />I,fl.l.n. Tl)ti Hf1LlTTrIpTN(:-Cic T.i..T-o- <br />EPA Fwm 33261 108-961 Prevloue edtoone may be used. /REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.1 PAGE OF <br />00138/a77C31-151 1 <br />- ~z ~;- .- <br />