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PERMITTEE NAME/ADDRESS pnclude Faci/irv Nome/Laeo»an ifDifferea)
<br />NAME CfPH,;j YA"~A VALLEY COAL CORP.
<br />ADDRESS"IBS:; 1,2E3 SOU7N, E ECK~1Atl PK
<br />y1UU GA`i'f .."I":.'dAL CIRCI.c
<br />~NGLSG~IUU CO 80155
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<br />LOCATION
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<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDESJ Form Approved.
<br />DISCHARGE MONITORING REPORT (OMRj OMB NO. 2040-0004.
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<br />Approval expires 0~'=3r1-98
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<br />NAME(TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMILIAR WITH THE INFORM LAW THAT I HAVE PERSONALLY ExAMINED AND
<br />ATION SUBMITTED HEREIN; AND BASED ON MV TELEPHONE DATE
<br />
<br />Richard Milis fNOUIrTY OF THOSE INDIVIDUAL
<br />THE INFORMATION, 1 BELIEV S IMMEDIATELY RESPONSIBLE FOR OBTAINING
<br />E THE SUBMITTED INFORMATION IS TRUE. '
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<br />Environmental Manager ACCURATE AND COMPLETE.
<br />TIN I AM AWARE THAT THERE ARE SIGNIFICANT
<br />INCLUDING THE
<br />NFORMATION
<br />FALBE ~/
<br />^" 970-870-2712
<br /> pENALTlES FOR SUBMIT
<br />POSSIBILITY OF FINE AND IMPR ,
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<br />ISONMENT. SEE 18 U S C, § 1001 AND 33 U.S.C.
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<br />EPA Form 3320.7 (OB-95) Previous adihons may not be used. (REPLACES EPA FORM 7-40 WHICH MAY NOT BE USED.) ^ ~ ~ 3 .S / U U 0 4 0 5 - : ~ C 1 PAGE I OF
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