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PERMITTE6 NAME!ADORERS(IWrLF.emryHeYWfetAe~89~i7wNj--. ~- ~~ ~ -- <br />NAF'tE PONDE$EIORlE COAL COeYAiS <br />ADDRESSA0AU5IDE PIINF., N E S PORTALS <br />P.o. sox Iu3G <br />PA:.LSADd CO 91525 <br />FACILITY <br />LOCATION <br />n'iTN: JOHN A. PICNAR. F3ESIDr.NT <br />NAi1eNAkTOKarvw>~scH~ aE~~NN~~INNy~aa-oNSxssENNAIpOESt-`~ -_ -- - .- .~~.- -- <TwrFgFAPProve ''° +-. <br />.. -915CHARGE ON~ORNiGHEP -/DD~MR)I~ - - . <br />11-15, -1J TO aB/iYD Tale/caL P - a ;~ ~.se <br />~ (SURR YC) 12J4 fi`' <br />PERMIT NUMBER DISCHMGE NUMBER ° _ F T t, A L <br />' MONITORING PERIOD ~i NOF . <br />YEAR MO DAV YEAR MO DAY <br />FROM 9 10 O1 TO 99 12 31 ~, NO GISCHARGE ~~#r= ~,•~~~~ <br />174711 111-131 /II-151 116771 178-191 I3O371 Y NOTE: Reed Inetructloro before Co plstinp thN form: ~~ <br />PARAMETER l3 Grd Onlyl QUANTRY OR LOADING !I Grd On/yl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE <br /> 14653 !5461/ 138-151 !1653/ 15461/ <br />EX OF <br />TYPE <br />l31-371 MALY515 <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS /Ft~es/ 15b681 159-701 <br />1jj SAMPLE ;k#a### ###a## +3##G#;: ( 12) <br /> MEASUREMENT <br />0400 1 D -U ..PERMIT #aa.tr;ua ..#44111#~ ### , 5 ~ ~ a:a#a#a 9,'0 ~ ~ .~. .;B.BBLY : N5IT!J <br /> <br />dFPLUENT GROSS YALU 'REQUIREMENT <br />a#aa <br />tly <br />~L;LIDS, TOTAL SAMPLE #aa### aa~atL# #aaaa# [ 19) <br />OSPL'NDED MEASUREMENT <br />JUS30 1 0 0 PERMIT::-.;.: area RlY'ar ' :: #il «>a.lllO a## 4911a11116?I 35 ~~} [ i1CE/ :RAE <br />FFLUBMT GROSS YALU REQUIREMENT a~.0a ~, <br />Lxoe, TOTAL SAMPLE #a#a:.# ####>rA# #aa#aa ( 19) <br />(AS PE) MEASUREMENT <br />1045 1 0 D PERMIT ~~#4,y0c. ~. ;,#ti,g.~tp ~ ##k {x 4aSa# .3,5 Ji0 ~ NCE/ :RAB ~' <br />~PPLUBMT Li$OSS VALU REQUIREMENT ayr#a <br />7IL AND GREASE: SAMPLE ####~r #,`.#### #####4 ( 19) <br /> MEASUREMENT <br />)35112 1 .0 U PERMIT 4##axtt #a##GIpI ##: a#a#aa REfORi 10 < UN".'IN :$AN <br />Ff'LUEMT GROSS YALU .REQUIREMENT #.;Ox fl V PIl C: <br />'LOY, IN CDNDUIi OF SAMPLE ( 03) #t5###- #:t##~# #>:;;##>; <br />i'HRD TAEATN£NT YLA RI MEASUREMENT <br />~OU50 1 0 0 PERMIT ;EpOAT YEPA.EiT a>Qaaa# a#asxwa #a+pA##. at~a EEriL'i .N~TAN <br />FPLUEiT GROSS YALUF REQUIREMENT 30DA AYr, DAZ Y MGD ###a <br />:,ULIDS, TUTAL SAMPLE s=iFG#u:: #s:##•r# as#a## ( 14) <br />I:iSOLYEO MEASUREMENT <br />)U29S 1 0 U PERMIT ~:~#a::r ~:##aa# ,... TAaoaau RYPQR; REPORT TR.I,Y ,AA9 <br />FFLU6NT GA055 VALU REQUIREMENT ##:# CRTF 4YG RTB !!AI E1G L <br />~tL -ND GREASE SAMPLE ;=#a:>#;: ( Sty) ##w*#>~ ###a## : s#>~## <br />L S U A L MEASUREMENT <br />4UO6 1 0 0 PERMIT 4#t>il## REPORT Y ES=1 410aa## ~x#~##a ;+*,#>i#. ##v EEKLT ISUAL <br />FFLUER'f GROSS VALU .REQUIREMENT 1;)gg .hAX NC=O a. ',:# <br />NAME/T1TLE PRINCIPAL EXECUTIVE OFFICER I CERTI <br />AM FA FY UNDER PENALTY OF LAW TNAT I NAVE PERSONALLY E%AMINED MD <br />MILIM WITH THE INFORMATION SUBMITTED HEREIN; MD BARED ON TELEPHONE DATE <br />G ~ ~ y~ <br />J.G ~ yy v MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br />OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS <br />ACCUMTE MD COM0.ETE. I AM AWME THAT THERE ME <br />TRUE <br /> , <br />SIGNIFCMT PENALTIES fOR SUBMITTING FALSE INFORMATION, INCLUDING ~ ~/C~ alJ~ <br />~ Vv <br /> <br />THE POSSIBIUTV OF FlNE MD IMPRISONMENT. BEE t8 U.S.C. E 1001 MD 33 <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />N` O / <br /> U.s.c. f 13te. lPNMIFY. ISWw dlr~ meets .IFr /IFNd. r.wa w ro tIO,IX10 AREA <br />TYPED OR PRINTED wa•mubNnt Nlprisrvrwta/MMwnFmonera rwFyera/ OFFICER OR AUTNORIIEO AGENT CODE NUMBER YEAR MO DAV <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS IReterence el/ sffechmenfs here! <br />THIS OU'fFALL IS NOT ELIGIBLE FUH ~'xEHPTI085 FR01 TOTAL 57~PPNDED SCLICS (TSS), 10TAL IZOR AND/OH <br />S:;TTLEARLE SOLIDS LIMITATIOd~ - SF I. A. 2. <br />i <br />f ;~ <br />b ~y <br />r. <br />EPA Form 3320.1 108-95) Previous editions mey bs used. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.) fl 077 4 /9 8 L 22 3-1256 PAGE 1 OF <br />