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PERMITTEE NAME/ADDRESS Q.~iFSfbryNNdlccanu l/DIDGrmj NAME `CNYNTYMILF: COAL CG ADDRESS 9100 EAST [1INCF.AL CIRCLE P.O. ep% 3249 , Ct7GLEN00D CO BOSS FAaLrtv TNEdTY17ILE COAL Cu LocniwNOAK CpHFA CO tl046/ ATTNS RLKR REf: l.FY_ CkN PFBI ATT/10 NGY Form Approvved. PGHr., '•E" CISCHAR~~B~~j aRp~~0531=98 (SURF NN) 1[345 F - FINAL !1INOR s3 7>rfi NO DISCHAIIf.~ ~ #oa NOTE: Reed Mewctlarw be a IC6ERp tiny this form. PARAMETER /3 Grd Oniyl O.UANTITY OR~ ( MOn/yi QUANTTrY OR CONCENTRATION Np, FREQUENCY -SAMPLE /3Z-371 /16531 /5f-671 38-16 !1653 5F61 EX of MALVSS TYPE AVERAGE MAXIMUM MINIMUM AVERAGE MA%IMUM UNITS. /rrea/ /µ6N( /6s.7w OIL AMD GREASE SAMPLE :~;...;;,_ ~ ~ r;: ..a;.,; ~ ,w:D~.;~ O I ~ ~6 VISUAL MEASUREMENT Vk :. $4Ubb 1 D o .. : ~:P{RMIT:~.:.. ~... ~~~ ... ~sl#~rs~ .. ~ ~ .... .. RB'4?Q7tT. a ;=1 .. ~?Y~±F~±~ ~x->; ~ . ... .. ' :..~~~>s~.~: ae~+ ;... Y:L-8.1CL 1t35t1A., ,,, .- ~~RE~OIREMEWT~~ :.. .. .: ... ':. .. ... ,.. SAMPLE t, MEASUREMENT y..~ " ~ r . , .:.PERMIT; .. ' : ~ . ,.. ,,. : :oaf: :' ~ " ': .':.;, . .. : ~ i::: ~.::.:~.:~ y~ %`-`` ~.RE4E11REMENT~ ~.. :. rr':: ..:. ~. ~:.:as ~-i: ~.~ . ; .. .. . SAMPLE MEASUREMENT r g¢ ..:: : ' REn01REMEN'L"1 .. ':::.. ;:.s..::.::.,.;.: '. »: ,.. ,.:•: ,. . SAMPLE -- MEASUREMENT .. ':: ~ PERMIT ~ :.. .... ~: ~..:.. ..o:;':' ~ .,.. ,.:.:~ .. ,..z... .: .~. .. ,REObIREMENT ,.:.:. ~~ .~~ ~:.::...~.«:. .. y~z:'.~,'::~.;..;:.: SAMPLE MEASUREMENT '~ ~ r '.. .: ~PERKAIT.: ,~ .. .~ ~ ~ . t:REOU.IRENIENT~ ~:. ~:5 ~ ...., `~°~ :,..r. ..... .,.::.:.: : SAMPLE MEASUREMENT -- :.:. PERMIT:: ~. '.: ~ ~~: ~.:::~£~ ~'.'~:.~.;r:: y.:.;; .... .: ~:. .. .,., :REOUIREMENY .. -~~:. ..~.. ~::.~< c.r ~:. .: .. ... . SAMPLE MEASUREMENT - ,..... ~ RE.QUIREIUIENT. •; :r, .. ~ ...: .. .. . ...: ~..: ~~. .. ~: ~ ~.~:~ r>:.~~::.::s:; .... NAME/TRLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDD1 PENN.TY 0~, 1}~w rNA~ L AvE PERSO ~ Nr~LLY E%AMI NED AEio AS TELEPHONE DATE Richard id i 11 s - AM FAMILIM WITH THE 1NFO MY INOUIRi OF. ?NOSE 1N OBTNNING THE INFORM BMITTEO•NEREIN; MD B RFiATION S DU S~IMMEDIATELY RESPONSI f BEyEV[ THE SUBMITTED INFORM ED ON BLE FOR ATION IS ~ ~ Environmental Mana er 9 TRUE, ACCUI(ATE MD C A SICNIFlCMT PENN iIE3 1F0 1S pdLETE- ( AM AWME TNAT TH ~MDYINO FueE INFORMATION IN ERE ME CLUDING ~7~ 870-c / 12 ~ . . THE POSBIBIUFy pQff FlN 1 A` , PRISONMENT. SEE 18 U.S.C. 1 1001 MD 77 Q~ 7 ~ ~ late: /lirrtl~%InO.r dMN mnm. mrv /x.'aw rws Ip ro t 10,000 U.S.C. 1 CIONATURE OF PIiIMCWAL. EXECUTIVE A A TYPED OR PRINTED . //Id (M /IrRMMII/IIW:RM/ll(nr 0/OIfANI1 f /AY•Clr rld 6 yWal OFFlCER OR AIffHORQED AGENT GODE NUMBER YEAR MO DAY ,i COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRdarmEe e//eEbcnmenro hers/ T55 6 TO'PAL IkON LI!!ITS 4ILL P$ NAIY$DF AHD SETTLEAPL£ SOLIDS CiMIT APPiIED PCA <=10Y8E2UHP. PRECIP EYENT- Set 6URDEN OF Pfi00F R°UUIRElIEMTS UNDER I. A. 31 P. 4. GIL E ,RE.ASE - SFE I.9.l.U. 30 DAY AVERAGE IS EP dim 0- - Y• Pre ou dditi- a `IREPLAiCEB EP F M -40'INMCH MAY NOT BE USED.) PAGE OF 00037/961282-0915 2 _.