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PERMITTEE NAME/ADDRESS (include Fatilirv A'ame'Comnan ijDi$¢renJ <br />NAME ~. . <br />,,F,Ml;Ca COAL CClIF/RT <br />ADDRESSDYAYEE D <br />BATDEY CO 816]4 <br />.NATIONAL POLLUTANT 015CHARGE ELIMINq ~ STEM (NPDES) <br />DISCHARGE MONITORING PEP - MR <br />rz~wl ~ x 'nr-;sl .;. MINOY <br />NUMRER ~ DISCHARGE ER p- F I Y A L i," <br />MONITORING PERIOD...:-' ~ piSCHAj7O <br />. ~ <br />Farm Approved. <br />OMB No. 2040-0004 <br />Approval expires 05-37-98 <br />~Ic vg z <br />6t~ASSY CFEfK <br /> <br />LOCATION <br />dA[DEN O DAY <br /> <br />CO b1E30 <br />l YEAR MO DAY ~r ~ <br /> <br />y j' ~l ~#-"`"~` "'' ; p ~ <br />~ ~ ~ 6 G 4 { ~- { <br />'(~ <br />^ <br /> I <br />FROM 1 i0 <br />~ nstruc <br />; ~ tions before completing this fo rm. <br />A?T & : G . bli U b A O ii Y ~ 6 ! N $ R A L MANAGE 6 (za-zp (zz-23l (T4.zs . (2s~zr) rzass) (3G3t1 . A1 <br />~ <br />C SAMPLE <br /> (3 Card Onry) QUANTITY OR LOADING ~ ~~ iy) QUANTITY OR CO ION <br />(54-51) ~ FREOUEN <br />y <br />OF <br />"$;X.: TYPE <br />PARAMETEfl (.46• J)" (54~61J <br />` 4 -45 (46-53) . <br />nNaLrsls <br />(32-37) ~ <br />AVERA - ~. MAXIMUM UN <br />• ~ UM AVERAGE MAXIMUM UNITS <br />(~ ~,; ~. {s4-se) 69-70 <br />IL Ad G E . <br />SAMPLE "~'~'R <br />( <br />- <br />~ •~o - ~ ~ ~~ <br />Ui5 <br />VISUAL ~ <br />MEASUREMENT ~_' <br />. ~ <br />-.. ,. <br /> <br />• ~ - <br /> <br />~~ <br />duUbb 1 0. 1 PE(iMlt>' IS=1 <br />sr ~ <br />1- ~. <br />~ <br />ictl E -; <br /> <br />EFFLUEYT 6YUyS YALOF <br />~9Ult~6Ni,~N , >e0 , , <br /> SAMPLE <br /> <br /> MEASUREMENT <br /> ~~~~ ~-" <br /> IREbi ~ <br /> <br /> <br /> SAMPLE <br /> ENT <br />E <br />~ <br /> MEASUR <br />M ~~ <br /> " <br /> /~ p Q)jY~y a <br /> tiF <br /> <br /> SAMPLE <br /> M <br />NT <br /> MEASURE <br />E <br /> <br /> M~AtT ~ . J <br /> SAMPLE ' ~`~{'~•~ <br /> EN <br />T <br />MEASUREM <br />. <br /> r; ~°. <br /> ww <br />TT <br />CIA <br />... 4 ~. ~: ~ Sys!... .i. <br />y Yt ` <br />Y <br />{~. , <br />{- <br /> SAMPLE ~. ~" .,,u ?~~~. <br /> E ' <br /> NT <br />MEASUREM <br /> <br /> RN4f•r.1i- k'' ~~~ <br /> <br /> SAMPLE <br /> _ <br />~~ <br />~ <br /> MEASUREMENT - <br />k. <br />-~~ <br />T ~ <br />~ ~'~ •~ <br />,,i~' <br /> ~ - - 6 <br />*fi - r -,kt <br /> ¢ <br />~ <br />w, . ~ <br />.n. <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW.XFj~I NAVE PERSONALLY EXAMINED AND <br />AM FAMILIAli WITH THE INFORMATION SuDeef.11TTE0EHEREINt AND BASED ON MY TELEPHONE GATE <br /> INQUIRY OF THOSE INDIVIDUALS IMMEOTFTELV RESP~N$IBLE FOR OBTAINING <br />I RELIEVE THE SUBMITTED NFORMATION 1$ TRUE, <br />TION <br />RM <br /> THE INFO <br />A <br />. <br />ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT /~ <br />v <br /> PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING THE <br />C <br />S <br />§ 1007 AND 33 U <br />SEE to U~S <br />C <br />MENT SIGNATURE OF INCIPAL EXECUTIVE / /v <br />v <br /> . <br />. <br />. <br />. <br />. <br />. <br />POSSIBILRV OF FINE AND IMPRISON <br />(Penebes antler these s(almes mey include lures up ro d10,W0 end or <br />§ t31 B OFFICER OR UTHORIZED AGENT A NUMBER YEAR ' MO bAY <br />TYPED OR PRINTED . <br />maximum ~mpnsonmerrt of Denssen 6 months end 5yaarsJ <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference au atlecnmerns nere) <br />T55 8 INOR LIRITS YlII BE YaIYEa E SEYTLEA918 SCLICS LIniY APPLIED F06 <=]OTh,~pBh FBEtLf 2lEIITi 759, <br />I1iQD G SE2YLEA8LE SGL1D5 LIlIITS ~TAIYhD FON 710TH•i4XH QFECI(r PYEMT SUE~FCT 20 PGECE~ C! fICGl.I/' 1•A •1• <br />- - - - - -~` <br />