|
PERMITTEE NAME/ADDRESS (/nc(ude Fanlin•Name/Location iJDi$erentl
<br />NAME
<br />CYP'!!'b YAN~h V:11'Y COAL COhF•.
<br />ADDRESSq j fi E ~ 1 , I t; 3 'i Cl .. ^. ~ t, ` EC N ••! A '+ P f:
<br />ylUO tA]T -'.I`Ii9AL CI~CL~
<br />FACILITY ''GLFyCOD CL `>UISti
<br />LOCATION
<br />+PPN~ nt f144 TC ~'_ KFCr c4 ^PYC Jd I. OT>:V
<br />NATIONAL POLLUTANT DISCHARGE EOMINATION SYSTEM (NPDES) Form Approved. "„
<br />DISCHARGE MONITORING REPORT (DMR; OMB No. 2040-000
<br />(z-IS1 r11- 91 h A JO R Approval expires 0 -31-98
<br />PERMIT NUMBER DISCHARGE NUMBER F - ° I :1 A L hU'. T,T
<br />MONITORING PERIOD t+l r: r' 1, F O h L H .' C !• i L L L ~' C B `-
<br />YEAR MO DAY YEAR MO DAY
<br />FROM OC U7 O1 TO UU 07 31 y; ts4 f•0 CISCKARCF Y'%~~
<br />rzo-zn nz-zal r24~zs1 (zs-zrl rze~zsl r3o~~D NOTE: Read Instructions befo!e w Ipfefing this form.
<br /> (3 Certl Only) QUANTITY OR LOADING (4 Certl Onry) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br />PARAMETER 46-53) (54-67) lie-45) (46-53) /54~st) EX of TYPE
<br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
<br />(62-tp) ANALYSIS
<br />(64-6e)
<br />69-70
<br />.. SAMPLE :::;::X -::f ##G#'`:;: ~
<br />~ ~, F+.,t;r T
<br />Q I ( 1 2) O ~ ~R
<br />
<br />MEASUREMENT , ~ P r 7 FW
<br />J l'~4 (iU 1 U U -~.'PERMITX/'. . #fi##/!# l a ¢I~#Mil~:.~~ ##.`• •,~~ ', $•07DIf1~{;". .. 9, p' "..- ""~N ~EICLyI f1,-B`,.;
<br />F'LUEN'T GHU"~ S YALU F. ~f)EOUIREMEN7 - q,+w.„~`!. ~`; #### 1l,~-'~.L ~ ~} ~ "` , z `~',~~.:: tSAEi$U!! :. SU
<br />"C)LIDS, SF:TTT.EABLE SAMPLE tt :,`, .x v #'~` t#C R##p#tt !, ( 25)
<br />~ `L '.
<br /> MEASUREMENT /~/~ N A " u l4 rv
<br />:US4 S P U U >x*PERMIT
<br />.. _ .
<br />
<br />~ ##it##4l ' ;_ ~
<br />~;
<br />
<br />~
<br />" r
<br />-
<br />(' t#G
<br />g
<br />` -
<br />f t
<br />'!~ ~ :~d,. ~ - .)Nf
<br />
<br />
<br />~ ~,~
<br />
<br />.
<br />yy
<br />~
<br />A ,s,~ .'
<br />
<br />
<br />,~
<br />tNTS BELOA
<br />COQ: C' EbUI)7E~•1ENT
<br />@ •~s
<br />,-
<br />"
<br />z 4 ;#4 Ir'"'~~~ri `~
<br />z ~
<br />~•~ ~
<br />~: NL/L ~
<br />• ,
<br />• f I
<br />_ +
<br />~•
<br />3i,LIDS, SETTLP.]lHLE SAMPLE .,x-.x;rx=a ###*4a ######
<br />~ ( 25)
<br />~
<br />'
<br />'
<br />~~
<br /> MEASUREMENT ~•' ~ Q. ~ ~
<br />~r; 1
<br />1Uh45 1 U 0 `..PERMIT #4###.Ac _>>-. ~IItr>~~9QF°x911 43# fCc¢it~t# B~FQRT= r~~S-~ ~" ~ O ~C'(~i+,':
<br />dFt'LUthi' vHOSS YALUE -
<br />.REOUIREMENT '= #4:`-y+ 3Q1}~ kYti, DA?-~~ .mI .'iL/L 1162 r
<br />"
<br />/IL G is heASE SAMPLE ^34 •#; "'c'`r`r.: =F#f,Gsr# '"}'~##~ ( 1_9) I ~ ~/~
<br /> MEASUREMENT ~ ~t ~
<br />~{
<br />iU1S6 1 U U '=.PERMIT - YA1"rYFgtflfk - ' .'. YX~rtl#ITR,4 r;7Q x~4# #Ctl'#~!# y` - #IFdl i'+#it - (. (},, .. - -~ ON'i?'~IIi ~.M ---'
<br />•:I'YLUF:".T i:K055 VFL'~r REQUIREMENT - #### I~$? SiIY' CG/L FNT"
<br />FLOM, 1R CON'JUIT Oh SAMPLE ( C3) r`3.##:~': #ri":3rt'= .:7x:::r:
<br />~
<br />/
<br />i'NHU TKtAT CtENT PLAk? MEASUREMENT 4•QQ~$ Q.QQ~ A)
<br />7:)i15U 1 0 0 -PERMIT ~ REpORT ~ ?I+?IL)1{!f n~
<br />:.: Os~-yi,~iXS4r-- '"##'>,}".; $#P# ~ G4# 5~?.~ $~~~,Y' -#5'C7}:'N
<br />t"t'LU BNT GROSS VALUF REQUIREMENT -jUDq Arc-' y~
<br />-DkILC ~'%:j t!GD • ~ ~ 'L') i~'° ' s„
<br />ALL AND 'aREASW SAMPLE :`:~'~'^'~^ O ( 94) ####L:3 i:;:#### ###34#
<br />O
<br />~h
<br />V~suAz
<br />J : S (JAL MEASUREMENT ~
<br />,'l l:hb 1 U U ,PERMIT 4#XsAI#4 rxg~ 85=1 ~#~#4%r,~ - ##SttkliT~`S' ,a -~~ >tp ### ~%`~p $EKLY ISUAL
<br />"'r F'L 11 EST GKOSti VALUh 4REQUIREMENT 1tj$~,.~<~;)~"' TO=Q ~ -- ~" #444
<br /> SAMPLE
<br /> MEASUREMENT
<br />'P,ERMIT ~ ~ "
<br />REQUIREMENT - '--~ '~---- -
<br />NAME/TITLE PRINCIPAL E%ECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY E%AMINED AND TELEPHONE
<br />AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN; AND BASED ON MY DATE
<br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTPINING
<br />Richard Mflis THE INFORMATION. I BELIEVE THE SUBMITTED INFORMATION IS TRUE, /~
<br />ACCURATE AND COMPLETE. 1 AM AWARE THAT THERE ARE SIGNIFICANT
<br />Environmental Manager PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING THE 970-870-2712
<br />POSSIBIOTV OF FINE ANO IMPRISONMENT. SEE 18 U.S.C. 4 1001 AND 33 U.S.C
<br />SIGNATURE OF PRINCIPAL E%ECUTIVE
<br />TYPED OR PRINTED g t3t9. IPenetties untler Ihese statutes may inclutle lines up to E10,000 entl or
<br />maximum impnsonment of beer>3en6mpn(hs entl 5yners.J OFFICER OR AUTHORIZED AGENT ADp NUMBER YEAR MO DAY
<br />(i
<br />'.%
<br />``
<br />F
<br />COMMENTS AND EXPLANATION OF ANY VIOLA I IONS (Reverence au artacnmenrs nere)
<br />. r:';TLF.AtlLc SOLITiS LIi"Ii IS vAIVEL (LOC 'P') O6LT IF >10-Y U, 24-HH. F4ECIP ~V'S9T IS t:LA7"ELI. S(:L I..*_.2,
<br />.~ lh, h'O!c dUt1Di-N OF PROOF hELUI.".C:'.F'iT;i• OIL f, GFEASF.-SEE FOOTVOTt Y/, PG 1. kBTPLY S.1'PLifIG b
<br />EPA Form 3320-i (f18-95)~ Previous`ediiions may~not be used. ~' ~ (REPLACES EPA FORM T-40 WHICH MAY NO7 BE USED.) 0 O 1 0 5 / 0 C 0 4 C 5-15 C 1 PAGE 1 OF
<br />
|