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PERMITTEE HAMEIADDRESS pwdrLirWryNsWf<rulm UDI~ ..p NAME COLOMYO CDAL COMFIIdY L.P• ADORESSCOLOWYD nrae 5731 SYATE RIGRWAY 13 nEEKER "" CD 81641 FACILITY LOCATION ~ ~ .~°" FRI Form Approved. S?REFT!R GOLCR TOOMBJNo~zD~40~004~ R (S')9R 1417 APProvel e%~rr=e705-31-98 F - FTNAL l[ NitiOP. 'k'`'t Rn DISCHARG£ {__{ axY NOTE: Raed imtructioro before complatinp this loan. PARAMETER !3 Grd Onlp QUANTITY OR LOADING _ V`" !lGrd Ori/y1'::QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE It6-531 ~ I546I ~ /36-15%~~'~. ME53 I5L67/ DF l3z-371 ~ ~,. ~ .. : EX ANALrsIS TYPE AVERAGE MAXIMUM UNITS . . MINIMUM: AVERAGE MAXIMUM UNITS rs1-ss~ 164581 16&701 DIL AND GRERS>? SAMPLE ::#G.v.r ~ ( g4) ~'e;~y~ Gx~x~M»». ~~#«r:~: ~ I<e 1/SVAI I VISUAL MEASUREMENT - ~ p B4U66 I D 0 PERMIT... {r::;,•`c;.L>;:. `~. ~~~ , . y A S (~ -~ E .~ ~.. _y"~'+'fr.„,, F r:.r~!rr:.. .;;-~.:;y:.. ~ ~ 'CT+ Y K gqrnyy ~'A~J EPFLUP.NT GRDSS YALU . REQUIREMENT :, ., . TNS'"-+6~5 O 11flaF~~.f~4 • ' 6~`' '' .. ~v;23.:'`:...:. .4 JpL . SAMPLE ' '. ~' ~ MEASUREMENT . - PERMIT .. ~,..:. ~..~,..w..,; :~E,.:~.;::.::~::~ ~ .... .REQUIREMENT ~ ~ ~ .. .:.: ~~. . ~~......., d" ~~~"8" ....:. .. SAMPLE ~ ~ MEASUREMENT ~ : . .. -'- °='~~ ~' ' PERMIT: REQUIREMENT: ~ ~ , .. FE:i ~"- .. `.;j'~ K ~ ... ~;.,:.., .: .. es P .. ~.. i~.S.f SAMPLE 'T"' ~ ' MEASUREMENT ~~ PERMIT" ~' ~~ .. ': .... . ~ ~ ... :. .. ~ ~ ~ ~ .~ :•.. .-.. .: ~:~.. ~sisb.: <.... .,: . . :: ~ ~ .. REQUIREMENT ... . . . . ~: RECEIVED SAMPLE `_',,~j-";, ' , MEASUREMENT ~"I` PERMIT .. .. ::.: :. ~:. ~ _ , :.... REQUIREMENT ... , . ~ :o- ;,: .... ~::: .:.. .. ~...... ~: SAMPLE MEASUREMENT -, DIV. OF MINERALS `PERMIT ;. s;ts' SGEOLOGY REQUIREMENT: 'r :...:.:::::.:::'' ~~:F°:. ;. SAMPLE "' MEASUREMENT : :PERMIT...: REQUIREMENT ~ ~ ~ ~ ~` ~ .. .:_~,:.,.. ~ ~ .,r '~ ~ ... ~ ~ .. NAMERITLE PRINCIPAL EXECUTIVE OFFICER I ceRTI AM FA Fr UNDER PENN.Tr of MILIAR N1TH THE INF uw THAT I NAVE PERSONAUr ExAMI T NED Ailo ' TELEPHONE DATE ORMA ON SUBMITTED HERON; AND BA Mr INQUIRY OF THOSE IMDIVIDUN.S IMMEDIATELY RESPONSIB SED ON LE FOR ~ n~^I-~ •""~ OBTNNINO THE INFORMATION, I eEUEVE THE SUBMITTED INFORMA TION IS Wv, _ I ~r-~ I1 1, TRVE, ACCl1MTE AND COMRETE. I AM AWARE THAT THE 50NIRCMIT PENALTIES FOR eUBMITTING FN SE INFORMATON IN RE ARE CLUDING '" ' ' L Q ~ ~ O H . , THE POSSIBILITY OF RME ~ ~J ~Y.J~~~ ~S Ip I AND IMPRISONMENT. SEE 18 U.S.C. 1 1001 AND ]] A TYPED OR PRINTED U.S.C. f t Jte. I/rrkW rWr e'rar mnm. n..r InrA.d. rvrs ~ ro ,rw nmrirxnr inOr/enwrca/brwwremmtlr rWSyrrAl ! IO,000 BION TURE OF PRINdPAL E%EdJTNE -OFFICER OR pUTHORRED AOENf C NUMBER YEAR MO DAY ODE ~, mo. i v nnu ~nrLnnn I wn yr nn r rlvLn I was InerrlenQe an erreCOTIel3 ne/B/ "' ~ SETTLEABLE SOLIDS LZNTT APPLIES ONLY IP C= LD-YR, 24-RR PRF.CIP £YEaT IS CLAInED. IF CLAIlf APPROVED H.Y WQCD, T55 B IRON LICIITS WILL NOT BE APPLIED TO ~tEPORYRD YEASORErENTS--S EP. I.B.lA,..P6:t1 AaD I.B.1D, PG 6. ,c*norusrco r.6 Frer rr~ nr •r nne T_T _oa - ._.1~ .. _ _~.... s._ mey tie uead. MAY NOT BE PAGE 2 OI