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<br />PERMITTEE NAME/ADDRESS (Include Fanliry NOme/Goc¢non i/DiBe:enr)
<br />NAME BLUE MOUNTAIN ENERGY, INC.
<br />ADDRESSDC5E$ADO !1I N$
<br />3507 COUNTY ROAD 65 .
<br />FACILITY RAtlGLY CJ 81549
<br />LOCATION
<br />ATTN: JEFF DU83EftT
<br />NA710NAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
<br />DISCHARGE MONITORING REPORT (DMA)
<br />I
<br />' PERMIT NUMBER _. DISGNARGEN eER
<br />MOp1170RING PERIOD
<br />MO A9. YEAR MO DAY
<br />FROM , TO ~ 1 3 U
<br />t:
<br />Form Approved.
<br />OMB No. 2040.0004
<br />I.~uR
<br />(SUBR NR)
<br />F - FINAL 4N.LA'.
<br />31-5 LOADOUP,`T0, RED MASH
<br />~*xa D~SCAG:E II .K 1 se~4
<br />Rea O~Dtie ns befgfe leting this form.
<br /> QUANTITY OR LOAQ
<br />l QUANTITY OR 710N " - ~ N0:- PREOUENC SAMPIt
<br />
<br />PARAMETER z
<br />' EX of TYPE
<br />~
<br />- AVERAGE MAXIMUM Uh(RS MINIMUM AVERA MAXIMUM UNITS ~~~13
<br />Pk SAMPLE +:;'`?n4C ~*G,ktrf #r7tC4R~` ( 12)
<br /> MEASUREMENT
<br />OU4UU 1 J 1 °,P 6[yltT=~: '~ •~~~#~ .'=' °'
<br />~ fi~:Y #. 9~~;,„'„r-~,;~'
<br />Cf''FLUENT G.`i055 YALU A,FOUTAEM~tJi - ~'' t,.:,:•x•< ;~
<br />tiOLIDS, TOTAL SAMPLE ,: ``-S°: ::;:rr::~-: OY:rx~txa '. ( 19)
<br />SU~SPENUED MEASUREMENT
<br /> ~x+~
<br />EFFLUENT GROSS 'YALU ~ ~ LMT #:: •:: ;: ~
<br />" :„ I''i'
<br />SJLIUS, S ETTLF.ABLP. SAMPLE ~ ~ "'```'` •` %" ;t<:~as= ", s4 ( 1S)
<br /> MEASUREMENT
<br />UU53S 1 0 D ,, pen^ ~ : ;•dla~~t ,' cr ~#~4t 1. rE;.: ,a ~~' >_:' •. ~~ _
<br />E:FFLOENT GRO55 YALU AE9 MENT ~:~;:•.
<br />OIL (r GRE65E SAMPLE ~ ^-. ~ .,-.,,.- r:rr,:r,:y:# ( 19)
<br /> MEASUREMENT
<br />UJ~yb 1 U 0 {trig' '~dr0!APR f #Ar#is` ~:r~ ~k~Cd1f4~0~ dtif~~~bl:) .
<br />F F L U E 6 !. C R~7 S YALU ~ ~ ~IAkR'(L~It ~ ,
<br />~ ~~ ~ ~ '~
<br />I3Jli, T07AL SAMPLE • '""xx+`'
<br />......
<br />~ ~ ~ ~ ^~-'~ ~'~ ( 19)
<br />(~ ~ F') ~ MEASUREMENT
<br />U 1 J 41 1 0 U .. -' ti ,x r ! + -"
<br />a !I ~ #~4#~il'+?, ,~. fl ° . • (! ~,_,~ ~ .
<br />r:FYLUENT GROSS YALU Y• .
<br />~u;r' ~ 3 `'
<br />FL7S{, IN CONDUIT OR SAMPLE ( J:i) ~~~<`~": '' •."t'•:'t'~ ~a;xr•,^'`
<br />T!14U TR6ATM EN? PLAN MEASUREMENT
<br />5 J U S D 1 0 U ~ =g,
<br />~ ~ ° ~RP+ ,'. '''~Ptltl~ ~ ges4#' a~a~aap °., +~>a a~x $
<br />h;FFLUEkT 6R0S5 YALU ~
<br />!#ti~. EltAEtJT i>i li ~,::ll ~` q,~#~ ~ x f ~ ~„.
<br />JIL AND GREASE SAMPLE rr:'^-R ( qu) :x,^•~'.:~?' ....•:;<': '>:i:K==
<br />V L 5'1 A L ~ MEASUREMENT
<br />h4J6b L J U =,~ `.': v. ~###~ ~ - Fs=1 ~~#bO~_ ~a. dtlill'~ b #1~ #'sa
<br />EFFLUENT •GROSS YALU ~~ (`~ _ ...~ rO=U
<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER ICeniy under penaltydlaw that this tlocument and all anachmems were TELEPHONE DATE
<br />prepared under my tleenicn or supervision In accordance wim a system desgned
<br />S C p N S" to asswe mat qualified petsonn¢I propeAy gather ar,d evaluate the imoenation
<br />submined. easetl on my inquiry of the person or persons who manage the system,
<br />information
<br />the In/onnatlon
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<br />in
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<br />b
<br />th
<br />l
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<br />y respons
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<br />or those persons tliren
<br />~ r^ submmetl Is, to the best of my knowledge end b¢lief, true, accurate. and wmplele.
<br />yf J SIGNATURE OF PRINCIPAL EXECUTIVE / 7Q ~ ~ 3 ~ ( 0
<br />.
<br />I am aware that mere are signrlicant penalties br submitting lalse inronnaUdn, OFFICER OR AUTHORIZED AGENT ^ NUMBER YEAR MO DAY
<br />TYPED OR PRINTED indudin lh¢ ossib,ll offne and ,m risonmentlorkwwi violations.
<br />COMMENTS AND EXPLANATION Oh ANY VIUIJ111uNJ (rreterence au anacnmems Here)
<br />I'~5 S TOTAL IRON LIMITS RILL 9E ',i9iJ2U, At1D ~F.??'LF.ABL^c S~LZDS LIMT'.' APPLI=D F0~ <=l0YR,24RH PP.ECIP EV;'NT-
<br />SEE I. A. Z, PG Y, FOR FE~UIR%'1ENT~. JIL :;SedSt RFPDRTIYG-SEE C. y. 1. F, ?G YIL. Qft?RLY SAriPLING
<br />used.
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<br />005.d21OD0.717-
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