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PERMITTEE NAME/ADDRESS N,ebr irWry NwWLraNan (/D~innl) NATIONAL POLLUTANT DISCXMOE ELIMINATION SYSTEM INPOESI Form Approved. <br />OMB No. 2040-0004 <br />NAME CC,u.B'AFY'v COAL COMt•ANY L. P. DlscEwR61E MONITORING REPORT!/OM91 I r <br />~ppr Vel expires OS-31-98 <br />ADDRESS COLUMYO l7INE rnr-R rTT n1 ~ CLLCN E SEDI FOND Ibll'1 a.a.•. P <br />5731 STATE NIGH NAY 13 PERMIT NUMBER _k DISCNARDENUMBER ~lSU61IN#L 12345 <br />roevon <br />ncnnnn CV tl1b41 RI^ ~ <br /> <br />x <br />FACILITY ~ MONITORING PERIOD <br />~ <br />. YEAR. MO DAY .. YEAR MO DAY . ,~,a;. <br />~~ <br />LOCATION ~`~.~, <br />' <br />~ <br />FROM ~;,i~l ~. ' <br />TO 98 C3 31 ' <br />t93.•1AG: DxSCHARGE ~ ( ~~~' <br />F h d ~ I L t: A P 116'1'/'1 111=131.131-M1 17G77/ 178-781 !3431/ '~ NOTE:. Raed inetructloElt befor -tamplstinp thu form. <br />~ <br />PARAMETER l3 Grd OnlYl QUANTITY OR LOADIN G '~.~ <br />" I4 GN On/p QUANTITY OR CONCENTRATION' <br />~ N0. FREQUENCY SAMPLE <br /> <br />137-371 /4653/ 154-611 138-15/ !4653 ""t~{'154=511 "' <br />. <br />EX OF <br />~ <br />TYPE <br /> AVERAGE MAXIMUM NITS ,4 <br />, <br />MINIMUM AVERAGE MAXIMUM 'UNITS !s7-esl MUrss <br />15658/ !53701 <br />AIL AND GNEASE SAMPLE ;;;y~t;;~.; ~ <br />54) <br />HOC 9>}0 <br />~CS4sr ~C # <br />¢'¢¢~ <br />- <br />D <br />I/ <br />VI <br />Vr) <br />VISUAL MEASUREMENT fl 1 S <br />94U60 1 U 0 PERMIT ;:r;kC.;t:;: ) Y <br />cx <br />E <br />1 <br />~~'~ .Q I-: .~. <br />• j <br />~ Kl. ~CAfifi ~I...''.,w.:' <br />4'':' ~` t LBHLX 'ISUAL <br />EFFLUENT L:RO~S VALUE REQUIREMENT <br />;: <br />- •i"b ~ ., <br />~ <br /> <br />.. <br />? Y:: . itilisz . <br /> SAMPLE T.Z-: <br />, <br />, <br />, r?""" 8. ' <br /> MEASUREMENT . _ <br />. <br />. <br />'- <br />~` <br /> PERMIT .~. ...... <br /> ... <br />REQUIREMENT ~ ~ ~ ~.:::. '.:.:..:" .:.¢...: .. ;; .... <br /> SAMPLE <br /> MEASUREMENT ~ " <br /> PERMIT ::~~ <br />: <br />~ <br />:: <br /> <br />REQUIREMENT <br />.. ~ . <br />.: <br />~ <br />i: <br />.:: .:.:M<.:.~:: :: <br /> <br />.:: <br /> <br />.. <br /> SAMPLE <br /> MEASUREMENT t:: <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 />NAME/TITLE PRINCIPAL EXECUTNE OFFICER 1 CERTIFY UNDER PENALTY OF <br />AM FAMILIM WITH THE INFO uW TXAT I RAVE PEASO <br />RMATION SUBMITTED H NAILY E%AMINED MD <br />EREIN <br />MD BASED ON TELEPHONE DATE <br /> ; <br />MY INQUIRY OF TXOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR ~// <br /> OBTAINING TXE INFORMATION, I BELIEVE TXE SUBMITTED INFORMATION IS ~~/// <br />' <br /> <br />TRUE. ACCURATE MD COMRETE. I AM AWME THAT THERE ME ~ <br />~~((//ifll <br /> SIONIFICMT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INCIUOING <br />11 <br />~~ U , <br />THE P055181LITY OF RNE <br />D <br />PR /~ <br />Q <br />F <br />fS <br />N! N+011 M <br />IM <br />ISONMENT. SEE 18 U.S.C. 1 1001 MD 3J BIONATURE OF PRINCIPAL EXECUTNE lll ~ I!'.T U h <br /> U.S.C. 1 131 e. lPrWaYE I,W rMw .eremF nuY Ycpd, r.wa yF ro f 10,000 AREA <br />TYPED OR PRINTED rW rmu,nun Yrp4ovnrre PrNrwwn tlnwrors rWSF,rs/ OFFlCER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Relerenee e// effachmanfs heiel <br />SETTLEAtlLE SOLIDS LIHI'i APPLIES ONLY IF ~= 10-YR, 24-HR PPECIE EYFN1 I~ CL#IMPC. IP CLAM APPROVED 9Y <br />tiQCD, TSB 6 IRON LIMITS WILL NOI BE APPLIED TO REPGRTCD MEASUFEEEliS--9EE I.E.lA, PG 4 AIID I,&.1D, PG 6. <br />EPi4-Form "3320=1-IOEI-951--Pievioue-editions mey bs ueed.' ' "' /REPLACES EPA FORM T~0 WHICH MAY NOT BE USED.1 PAGE OF <br />,,.,. $~,~1~~,971J.1V;,04~1 ~ 2 <br />- , .. . . <br />-. <br />