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PERMITTEE NAME/ADDRESS Qnclude Facihrv Name/Loranon if UiJferenq
<br />NAME CYPll1;5 YANPA VALLEY COAL COHF.
<br />ADDRESS'1 I '. t:.`i 1, 1;; 3 S C U T H, E f ': K'1 A F C iS
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<br />L*:GL~ a00L' C1, y01~'1
<br />FACILITY
<br />LOCATION
<br />P.'I"1'N: SIC%'r?IS '~. KF.GL`Y, GCHE:HPL ATNY
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
<br />DISCNARGE MONITORING REPORT (OMR;
<br />COU02715t1 C03 A
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO_ DAY YEAR MO_ DAY
<br />FROM ~ v v~ L TO v v O> .] L
<br />f20~2D (2223) (29-25) (26211 (23.291 (30.31)
<br />Form Approved.
<br />"1 A,7 O " OMB No. 2040-0004
<br />Approval expires OS-31-98
<br />F - FINAL POGi'
<br />~IrF 1, FONC H 'IC FCICYL CREEK
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<br />NAME/TITLE PRINCIPAL E%ECUTIVE OFFICER I CERTIFY UNDER PENALTY ~OF LAW THAT 1 HAVE PERSONALLY EXAMINED AND TELEPHONE
<br />AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN'. AND BASED ON MY
<br />e DATE
<br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING
<br />Richard N1111s THE INFORMATION, 1 BELIEVE THE SUBMITTED INFORMATION IS TRUE,
<br />ERE ARE SIGNIFICANT (~
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<br />Env(ronmental Mana er ACCURATE AND COMPLETE. I AM AWARE THAT
<br />9 PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING THE
<br />POSSIBILITY OF FINE AND IMPRISONMENT. SEE IB U 5 C. 41001 AND 73 U.S.C. SIGNATURE OF PRINCIPAL E%ECUTIVE
<br />
<br />TYPED OR PRINTED § 1319. (Penartias antler Ih9ae stalNes may include lines up to E10,000 entl or
<br />maximum impnsonmenr of beMeenBmonlhs entl5 years.) OFFICER OR AUTHORIZED AGENT R
<br />O
<br />NUMBER
<br />YEAR
<br />MO
<br />DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Releience all attachments here)
<br />A i..?:. }tNA^':. LIMITS FOR TS:3, II!`7 !: ~ SE?1'L:'A:IL` :i i.LZGS (LCC rOr) ?.YPLY ONLY I° C= 10-: H, 24-i~~~ °"CIP EVENT
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<br />HI I I Y `~I TN^ PF'DIIGT TYfiN C'TPI'r'TTn YS-PnnT Mf1TC D/-
<br />EPA Form 3320-1 (08.95) Previous editions may not be used. (REPLACES EPA FORM T-40 WHICN MAY NOT BE USED.) (1 rJ ~ 1 , .1 / 1 •' D y J c - 1 ti ^. 1 PAGE 1 OF
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