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PERMlTTE6 NAME/ADOREGBpnWt. F.eWpN•.r/(yeulo~UDdv.wp ---- <br />NAME POflUeRHORIi COAL COMPANY <br />ADDRESS ROADSIDE MINeE 6 v ~ FOn PA LS <br />P.U. HOX 1430 <br />PALISADE CO N152G <br />FACILITY <br />LOCATION <br />.i1 TN: JUflN A. i^CNABr r:~. b'~ILEe~," <br />DISCNMGE NUMBD! <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAV <br />FROM U U TO <br />126211 !?2-131 17t-151 176-77I 1I9-191 !3431/ <br />$E6'f!f 4LT <br />(SUER iC) <br />F - PHIAL <br />I^.INOR <br />1-98 ~'" <br />~f <br />##>* No Dlscna~Ge ~~~ ~,# <br />NOTE: Read Inatruetiana bafora eomplatinp this form. <br />PARAMETER !3 6rd only QUANTITY OR LOADING !t Grd Onhl OUANTITY OR CONCENTRATION ND FPEOUENCY SAMPLE <br /> Ite-53 /5t-611 138-45I 1t5-63) 15t-5/ X GF <br />l32-37/ E <br />YSIG <br />MN TVPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS rs2-s.T~ . <br />!at-eel 169-701 <br />1,C:7U ~IATkE 4ENR 9C SAMPLE ~ ~h.#~3 #a#i7#,i $:#=A#i .~,. CAF#+!G ~ 23) <br />CcRIDUAPHNIA MEASUREMENT 7/oa ~ ~© <br />1 A113 Li 1 U U PERMIT :;s;:#~## ~ .~: 1C~i'~QIgE# ##: ~,ES.~ •OO.Oi ,pt<t lpyllCtil ~ ~#~s-~~.~~tF~ ~ <br />. fLR- .~ ~S RL~Y ~ `r t~~6 <br /> <br /> <br /> <br />Ff'LJi:dT i:ROS,, VALU REQUIREMENT ~ ~ <br /> <br /> <br />- <br />~ ~.. ~.:: '. :.~...~ .- <br /> <br /> <br /> <br />~ ##3# ~ .. <br /> <br /> <br />at.Jf..~l.LG$ <br />. <br />. .. <br />..•.. ,: <br />. <br /> <br />g <br />:. <br />... <br />::..:::.. <br /> <br />. <br />LC]u J'IATite 6HtZ AC <br />' SAMPLE <br />MEASUREMENT '.~~~#3#a a#>71~}`q) SS~ <br />f~(~~ #t#ae# #t#v## I .Q3 <br />\ ~• <br />~ <br />~ <br />i <br />iriC~HALES <br />.dYOC 1 O U PERMIT ##.=##ar~~:: ::.:`'0!'0.!~'.:.. ;jp~.: ~,.. ##a ~~::d~~.,~..: :.:...~>Jtip ~gpi~d~.'~: :: ^.~;::#O~iQ~4!,;: ~R~ ~ .:;':: ..ELT ;$~f! <br />FFLUBNT GROSS VA LUE .REnuIREMEN7 40a# L{1F:~'~L~1t CE i <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ - ~ - - <br /> REQUIREMENT~ ~ ~ ~ ~ ~ ~ ~~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ~ ~ .~ .. <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> .PERMIT ~ ~ ~ .. .. ~...~. ... ~ ~ <br />~ <br />~ .. <br /> ~REnUIREMENT ~ ~~ ~ ~ ~'~ ~ <br />~ ~- ' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ~ ~ ~ ~ ~~ ~ ~~ ~~ <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ~ ~ ~ ~ ~ ~ . <br /> REQUIREMENT ~ ~ - <br />:. ~ ~ ~ - <br />NAME/TRLE PRINCIPAL EXECUTIVE OFFICER I cERn <br />AAI FA FV UNDER PENN.rT of <br />MILIM WITH THE INFO uw THAT I HAVE PERSONN.Lr ExAMINED MD <br />RMATON GUBMITTED HEREIN; MD BASED ON ~ TELEPHONE DATE <br /> <br />G T I~ MY INQUIRY OF TNOGF INDINDUALG IMM WIATELY RESPONSIBLE FOR <br />I BELIEVE THE GUBMITTED INFORMATION IS <br />OBTNNING THE INFORMATON <br />J ~ r+• ~C~1 ~ , <br />TRUE <br />ACCUMTE MD COMRETE <br />I M1 AWME THAT THERE ME <br /> . <br />. <br />SIGNIFICMT PENN <br />TIEG FOP SUBMITTING FALSE INFORMATION <br />INCLWING , <br />7// /l.i <br /> . <br />, <br />P <br />E <br />ME <br />T <br />S <br />C <br />! 9~0 <br />7 <br />~/~'~//"'~ QO O/ O~ <br /> THE <br />OSSIBILITY OF RN <br />MD IMPNSON <br />N <br />. GEE 18 U. <br />. <br />. <br />1001 MD 7] 610NATURE OF PRINgPAL EXECUTIVE <br /> U.S.C. ! 1]1a. !P•rWelra uW Uww .YNH. mry hrh.N erwa IO ro rIO,aDO <br />TYPED OR PRINTED Wormu:nun inpl•awwnNMer.•n smoner •M6yval OFFICER OR AUTHORIZED AOENi CODE NUMBER YEAR MO DAV <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRarrranca el/ etrechmants nerel <br />Si:L PART I.b.4 FOR DE7AIL5 OF TEST PHOCEOUi,E. RFFOiIT LOIif:ST DILUTI09 (X EFFLUF.AT) WHICH IS LETHAL T.0 SOS! <br />!,F 'C EST OhGA9ISf15 (LCSU) AND ATTACH ACUTE TOYICITY TEST REPORT FO k!! TC CI+?. COFIES OF ALL INFORtiATIOR <br />*'):T RP Sn'NT TfT PD-- <br />EVA Farm 3320-1 108.951 Previous editions mey bs Veed. (REPLACES EPA FORM T~0 WHICH MAY NOT BE USED.! 00.374/98 G 223-1256 PAGE iOF <br />