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PERMITTEE NAME/ADDRESS (lndude Faeilip~NamelLOCafion ilDi$erenQ
<br />NAME
<br />FLUE MOUNTAIN ENERGY, INC.
<br />ADDRESSJE5ERAD0 MINE
<br />3607 COUNTY ROAD •S9
<br />FACILITYRANGLY CJ 81648
<br />LOCATION
<br />f~'!?iJ. JEFF Dl1BHERT
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
<br />DISCHARGE MONITORING REPORT (OMR)
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<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM 0 01 01 TO 00 U:3 3!
<br />Form Approved.
<br />M I 1JOR OMB No. 2040-0004
<br />(BURR NlJ )
<br />F - FINAL. RHLAN
<br />ACUTE WET TESTING FOR OU4
<br />~~# rJ0 liISCHARGE 1 I #~**
<br />NOTE: Read Instructions before mpleling this form.
<br /> QUANTITY OR LOADING QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br />PARAMETER ~ EX of TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANa.YSIs
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CedAy uMer penalty of law that this tlocument antl all attachments were TELEPHONE DATE
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<br />~ prepared untler my tlnection or supervision in accortlanca vnth a system tlesignetl
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<br />~~ submittetl. Based on ny inquiry of the person or parsons who manage the system,
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<br />subminea ~e , to tha best of my knowledge end beIIM, true, accurate, eM complMe. SIGNATURE OF PRINCIPAL EXECUTIVE ~G' "~ ~f']r~7T ~'' ~`>/ 5
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<br />TYPED OR PRINTED I am aware Nm there are signirmaM penalties for submitting false infornation,
<br />inclutlin tha ossibui ovine and im risonmant for knowi violations. OFFICER OR AUTHORIZED AGENT A
<br />NUMRER
<br />YEAR
<br />MO
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)
<br />SF-E PART I. B. v, PG VIII, F(Jfi llETAILS ^f TEST FFiOCEDURE. REPORT LC 5U - S~~ATIiTl( Ai Pr':;rJi l-'- ,-~i;i;~;;_ l„Ift)t~~,
<br />IS LETHAL TO 5U% OF TEST ORGANISMS, AND ATTACH ACUTE TOXIC ITV TEST REPORT FORM lC DMh ;nl;r.5 l~( ALI_
<br />or 32 - E P ou ltlo s b sed. THIS IS A 4-PART FORM PAGE OF
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