Laserfiche WebLink
RERMITTEE NAMEIADDRESS (1wal+F.rYrryNr./lc.u« yDICn..np <br />NAME iF~?lcCA COAL .: L)dh nSY <br />ADDRESS P. G. NU:( ~ /U <br />NAYl,ati CO t1iGi9 <br />FAaLm <br />L~T~HAYJc!! ::0 Ula3J <br />A?'.;+: '~.CvB riI'P;:Nf:N, GEVe!taL MANar~R <br />NATIONAL iOLIUTMT DISDMMOF RIMINATION SY4TEM /INPOfSI <br />DISCHARGE MONITORING REPORT (DA+R1 <br />rn~nr,n„~ nT ~ <br />PERMIT NUMBER dseNMDE NIXASm <br />MONITORING PERIOD <br />YEAR MO ..•DAV YEAR MO DAY <br />FROM pfy;;:,10,1.'.p3. .TO 'li JJ 11 <br />._~.,.:. :,n, <br />i' J': <br />(SIIyN Ji:) <br />t - FS tiAL ~ <br />ACUTB WE1' TESTING F'Uk 012A <br />ti. <br />~' <br />K~;t:~ ; <br />~'°NOTE; .R}Ad Irwtruetlonrr bdor~ oompbthq thb loan. <br />PARAMETER QUANTITY OR LOADIN G {~ ~ ~ + I ' ~ ``_' <br />QUd ~ 1 t Or~ <br />Y Concen'tra'~ti'I'on `NO+' FIIEOBD+cr SAMPLE <br /> _ of <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MA%IMUM UNITS EX MAtrss TYPE <br /> <br />LCyJ ''^:, n.,: '!h °i F: 4:: ~. <br />~ <br />SAMPLE <br />MEASUREMENT <br />.'.•r.~ <br />,,.•~,, .n /^~ <br />~ <br />4~n'k ~~'~ <br />'.f <br />( ,3) j <br /> <br />~ I <br /> <br />;' . L v ~' A i' H N i r <br />I IO[J L/ <br />4i7 <br />y ~ <br />'1'L.:3r 1 U 0 ~::..PERMIT ~: .'. .~.ale~.,; v: _~~.F <br />::-i: <br />. ~.: 'r ::.:::.: ~,y,~ <br />. <br />:~i;3i'J(~... .~..:'C~~3.:n':''~t:: ~.':. ~~ <br /> <br />.:: '~r:. :. ::: <br /> <br /> <br />;:; ,:: <br />;: Eck- <br /> <br /> <br /> <br />. .~ <br />~;FFLJtitiT ~ii7.;3 YALU, REQUIREMENT: :. r, rg~ _„~ <br /> <br /> <br />~ ,i}~iy~R: Fp:li'L: <br />,.:.... <br /> <br />:. C'NT <br /> <br /> <br />~~ <br /> <br /> <br />~ ~~ <br />P 1 (An . PIrO Vv~ . SAMPLE <br />MEASUREMENT ,~• J ` <br />~ 7 ~ Q~ ~ (~O ~,1ut+~ <br /> <br />G ~~.PERMIT:~~ <br />REQUIREMENT : ~ ~~ <br />(w ~ . <br />. <br />: <br />, <br /> SAMPLE <br /> MEASUREMENT <br /> : ',PERMIT .: .... .. <br /> <br />: ~ <br />~ ... ..w~ ... <br />:_ <br />: ~~; <br />:: <br />: . ...:.....:..:....~ <br /> <br />:: <br />: _ <br /> REQUIREMENT. ~~~ : .. .... . <br />. . <br />.'. : <br /> ..:: <br />... <br />.... .... <br />...: <br />....... . . <br /> SAMPLE . <br /> <br />__ MEASUREMENT r~~ <br />.. ~ <br /> <br />. .,. <br />~!, <br /> <br />_ <br /> .~. ~~ PERMIT ..~ .. <br />~ <br />~ <br />~ .... .. <br />:':.<... <br />~ <br /> REQUIREMENT, .. ~ ~: ~~~.o. ~... <br />~ ...;.: ~ . <br /> SAMPLE h <br /> MEASUREMENT <br /> <br />~ q,. <br /> ~~ ~. PERMIT:. . .:. <br />~ .: .. <br />; s:.~,.. <br />~~ <br />. <br /> ~REUUIREMENt ~: ~ ~. .. .. ... .. <br />.` .'~,... <br />~ <br /> SAMPLE <br /> MEASUREMENT <br /> ~.~.PERMIT:~:~. ~... :. ... ~.:. ~: - <br /> <br />... .. <br />., <br /> <br /> <br />. <br /> . <br />REQUIREMENT <br />.: <br />.. <br />~. ..::r <br />.;:., <br />. <br /> SAMPLE <br /> MEASUREMENT ~. , <br /> ~.~ PERMIT' ~ . .. .. <br />. ,:: .. <br />:I ' <br /> REQUIREMENT <br />. <br />~ :. <br />.. .. <br />.. <br /> <br />,, ... ,. <br />.:: <br /> .~ <br />NAME/TITLE PRINCIPAL E%ECUTIVE OFFICER 'vn~ry° ..p"•IJ°I.wln.l mbamlmrnl.m •°.Iln°nmr"°..n <br />/ TELEPHONE DATE <br /> pnynM Ultler ml tlllrrn°n erwpr.ltlon In amld.nn wllb•grlem tl..tlbnetl <br /> to nwun Ibtl qunnnN RnennM FreRrll L•Ibw nIM enlutlr Ibr Inlerm.lbn ~~ <br /> <br /> <br />wbnJnad. nnwa en mr I~Iqulrr of Ne preen n pnm wbo m.nnp IM.rrnm, / <br />\ <br />J <br /> or Ib~ Prw.e tllnrllr .vpeMbN fn plbellnL Nr Inlomun«, Ibe Infornullen <br />b <br />i A <br />~~` <br />i <br /> w <br />m <br />nN N. to lbe bl el mr Y«wYtlte nM bNlel, Wr, mavnle. nM awmplele. <br />Inm..nn unl men mre <br />mnnm <br />mi <br />f <br />b <br />l > / D ~ ' <br />D O~ <br /> <br />TYPED OR PRINTED . <br />pn <br />n <br />or w <br />m <br />mnb lnM bfennntlen, <br />IMnaIn.IM ~eemlf nrnnr.ntl lmF1lpnlRnl rorLm.InF .!d.uelu 610NATURE OF -f11Nq-AL EXECUTIVE <br />OFFlCER OR AVTMOIIIZED ADENT <br />CODE <br />NUMBER <br />YEAR <br />MO <br />DAV <br />......~....~. ~......... ................ ~. ..... ...........,w ,nwrwwmw wi ~oecnmmra nr/Tr// <br />., .,; F'ar;': I.a.lt rr":; ii U;i?ILJ JF TES: .~i;O~cC?Ukc. n~C.,k7 LOWEST DILUTL.:h ("b :.FFL'JCti1') :NICr. i5 LLT9AL TG SC%. <br />J.° Te. S'f Jr. .;AhISi".r (LC`.rf)) A„U a:TACd A^7T c'. i'JY I~ITY i`i :i 'I' kE PO iiT FOii>' TU D'!iiw <br />EPA Form a3zo•t ~ 3/99) Previous editions may be used. ~ This ~is a 4-parl•fonn. PAGE of <br />OO 11S/G1 v..1~1-iA.IJ ~. <br />