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PERMITTEE NAME/ADDRESS Qnclude Fanhry NamrlGocmron VD~erem) <br />NAME SEMECA COAL CCC6ANi <br />ADDRESSDfiAy ER D <br />NATDE.N CO 81639 <br />FACILITY <br />LocATION~AIDEEI C0 C1G30 <br />AT1M: G. BUD BR04N, GENEitAL MaEiAGEn <br /> <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOES) Form A roved!' ~ a* <br />PP q i <br /> <br />DISCHARGE MONITORING REPORT (OMR~ <br />(z~rsl !rl- 9) <br /> <br />!!I AO fi t <br />OMB No. 2040-0004 <br /> <br />ccococ~zi <br />c13 ~ <br />~sueR Approval expires 05-31-98 <br />xl) <br /> PERMIT NUMBER ``~~~;, DISCHARGE NUMBER E - FI (1 ~ L iC UST T <br /> ACUTE raET TE~TIIG FCF C131 <br />FROM %~~ NO 17°CNA6GE ~`X~'(/;~; <br /> <br />(zo-zp (zz~z31 (P4~2 5) (26-911 !PB-29) (3a3r1 ~ NOTE: Read Instructions befor cv' ompleting this form. <br /> (3 Card Ony) QUANTITY OR LOADING ~~!'. (4 Card Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (5461) '=~_~ `g' (36-45) (4653) (54-61) E% OF TYPE <br />(3237) AVERAGE MAXIMUM C1N~S MINIMUM AVERAGE MAXIMUM UNITS <br />(sz c31 ANALYSTS <br />/W-6e) <br />69-70) <br />LCSU 57'ATNE 4bHH ACf; SAMPLE ``~^~¢~_' if>rOO9 vaocoa aataao ( ,~) <br />CEHIUDAYNNIA MEASUREMENT <br />TAt13B 1 U U Y?ERMIT aov~usa ~ sa;c ~16~0~* +saRS~es.y EF- °, ti 7}LT.I )Aii;' <br />k:FFLUENT GRUS] YILUE - <br />REQUIREMENT' ; = n i ,'t~s_„ x„;p '~,, , _ - CE17 <br /> SAMPLE ' ~ `-~ '"~"~ <br /> MEASUREMENT `>] <br /> PERMIT- <br />REQUI <br />EME - : ~; <br />- <br />~ "I ~ - <br />~- <br />~~' ... 4°,, I*. ; <br />~ <br />? '"' <br />. <br />5 - <br />_ . <br />< <br /> R <br />NT ~ ~ s „ .`3 -u t -. <br />% <br />~ <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> --PERMIT - r`-• T<"~ ~ ~ ~:- ' <br /> REQUIREMENT ~ '-';~~ r ~; ~3 -r: ~ <,~t.- ; <br /> SAMPLE <br /> MEASUREMENT <br /> ` ; <br /> .FiEQUIBEMENT - - - ". ) ~~ ~1 «~ ;', <br />~" SAMPLE <br /> MEASUREMENT <br /> ' ."PERMIT- - <br />- <br />- - b= n ~ - <br />" - - - <br />~~ <br />~~~ .~ ~ , <br />~ <br /> REQUIREMENT' . -. - ` <br />~ - <br />' r ~ r,,. <br />, . <br /> SAMPLE <br /> MEASUREMENT <br /> ' s <br /> RE_OUIREMENT - - ~ <br />: - <br />, 7 - <br /> SAMPLE <br /> MEASUREMENT <br /> 1 -- <br />":PERMIT .." .., <br />r , ~.~ ~, - ._. <br />, ~ ; ~,~ , <br /> <br />REQUIREMENT <br />`F. ~ `;, <br />- <br />- <br />r . <br />,,,~ : ; <br />~ 5 , <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF <br />AM FAMILIAR WRH THE INFORM LAW THAT I HAVE PERSONALLY E%AMI <br />ATION SUBMITTED HEREIN <br />AND BASE NED AND <br />D ON MY ~ TELEPHONE w 'DATE <br /> ; <br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING <br />' THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS TRUE. <br /> ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT <br />PENALTIES FOR SUB <br />TT <br />G y `: ` <br />/ <br />I( <br />) L' <br /> <br />MI <br />IN <br />FALSE INFORMATION. INCLUDING THE <br />POSSIBILITY OF FINE AND IMPRISONMENT. BEE IB U.B.C. § 1001 AND 33 U.S.C. <br />SIGNATURE OF PRINC~L EXECUTIVE <br />l <br />/ <br />v U ~~ <br />TYPED OR PRINTED mazlmummnnslmmant oil berwse ~6 meonths entl5utle litres up ro Sr0.000 and or <br />p years.) OFFICER OR ALIT RIZED AGENT <br />_ - ~ <br />O p <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) ~ " <br />SEA PARS I.A.tl FON GEIAILS OF TEST PROCEDURE. RETC,RT LUYE9T GILUTiGN (. EtFLUEA7) iiNICfi,IS~IEIEAI TC SC'+ <br />OF TEST OR6AIYISMS (1C50) AYD ATTACH ACUTE TOYICI7! PEST REkOfl'1 FOF.N TC DNR. <br />EPA Form 3320-T (OB-95) Previous editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY;NOT•;,BE•USED.)~ ~ ~ _ OC 3 S ~/ 99 C t ~ ~ MI6 ~ 3 '~ ~ PAGE 3 OF <br />MONI TOF11NGjP.ERIOD <br />YEAR MO DA Y3?'~-° SYEAR MO DAV <br />un ut u ~ p uu u> >t <br />