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1.. <br />v[•-[M.TT AME/ADOR EHS (In[Jnde <br />F'acdiry Name/LoraNnn q diDrrenr) <br />"-""-~-~ ~ PEABODY COAL COMPANY (MESA) <br />"-D°"E=°~ 10375 East Harvard Avenue <br />Suite 400 <br />Denver, Colorado 80231 <br />~~ ~~ <br />Lo tenon ---~ <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM I,\'PDF.S) <br />DISCHARGE MONITORING REPORT (OMR) <br />_ _ 12J61 Il7d9l <br />PERMIT NUMBER DISCHAwGE nUMBEw <br />MONITORING PERIOD <br />III 111111111 IIII III,D OMB N~OrI58~R0073' <br />AU G u 1 19®4 <br />___ YEAR MO DAY YEAR MO DAY MINED IAND RECIAMAT10N ffIVISION ~~ <br />___ FROM TD _ Colo, Dept. ~f Ntiturei Nexources <br />rzovr (zazar rz+ssr assn rza z9r rao~au NOTE: Read instructions before completing thle loan. <br /> (J Card Only) OU ANTITY OR LOADING (1 Card Only) QU gLITY OR CONCENTRATION FR EOU ENCr <br />PARAMETER (46-SJ) (3461) (J843) (46-SJ) (3161) NO. <br />EX DF fiAMPLE <br />TYPE <br />(37.37) AVERAGE MA%IM UM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />(6763) ANAL r515 <br />(6468) <br />(69-70) <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIRHMENT <br /> SAMPLE <br />. MEASUREMENT <br /> PERMIT <br /> REQUIq EMENT <br /> fiAMPLE <br /> MEASUREMENT <br /> ' PERMIT ~ - <br /> REOVIREMENT • <br /> SAMPLE <br /> MEASUREMENT <br /> :PERMIT ~ , <br /> RHOUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> ,PERMIT <br /> REOUIREMHNT <br /> SAMPLE <br />• MEASUREMENT <br /> PERMIT, <br /> REOUIRlMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> RffOUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY E%AwNED <br />T <br />THE INFORMATION SUBMITTED HEREIN <br />AND BASED TELEPHONE D A T E <br /> . <br />ANO AM FAMILIAR WI <br />H <br />ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIgTELY RESPONSIBLE FOR <br /> OBTAINING THE INFORMATION I BELIEVE THE SUBMITTED INFORMATION <br /> IS TRUE gCCURATE AND COMPLETE I AM AWgRE THAT THERE ARE SIG <br />NIFICANT PENALTES FOR SUBMITTING FALSE INFORMATION INCLUOMG ' <br /> THE POSSIBILITY OF FINE AND IMPRISONMENT SEE IB USC § 1001 AND <br />uMrr (h <br />33 USC 51319 <br />lNr <br />5mh(ex ma in[(udv fines u <br />dIO <br />OW <br />IP <br />l SIGNATURE OF PRINCIPAL EXECUTIVE <br /> . <br />. <br />ona <br />x <br />ere <br />u <br />0 <br />A <br />fi <br />M1 <br />ds A A <br />TYPED OR PRINTED rtuwen <br />moN <br />n an <br />yearer <br />a.d/u.mA%Imum lmpneunmrnl n/ OFFICER OR AUTHORIZED AGENT HUMBER YEAR MO DAY <br />COMMENT ANO EXPLANATION OF ANV VIOLATIONS Inc/ervnce uu areunnnemx noer <br />EPA Form 0720.1 (Rev, lO.79) PREVIOUS EDITION TO BE USED fREPLAC ES EPA FORM T-90 WHICH MAY NOT BE USED.I PAGE OF <br />UNTIL SUPPLY IS EXHAUSTED <br />