Laserfiche WebLink
PERMITTEE NAME/ADDRESS (Include Farilily Name/Comtion ijDpemnq <br />NAME SE:h;,CA COAL CCf1tAHk <br />ADDRESSD H A tl 6' N U <br />HAkUEh <br />CO 816}9 <br />FACILITY <br />Locnnor~AkuE:w ca BIEJc <br />ATTN: c. NUU EHO~t, Ct;~txAL flANAGER <br />IAL POLLUTANT DISCrygRGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR; <br />(2461 (1]- 8) <br />' c <br />PERMIT NUMBER DISCHARGE NUMBER' <br />d MONITORING PERIOD <br />Y MO DAY YEAR MO DAY <br />ro u o> > <br />(A- . ~ (24~Y5) (Y6~d]) (28191 (30~J1) <br />Form Approve. •'M '-M <br />:' I ii C H OMB No. 2040-0004 ' <br />Approval expires OS-31-98 <br />~5u,~~ a ti) ` <br />I - PI!!I 8CU11 <br />DISCHAbGE 1C 7tl%it._h Cf1Eic <br />T• <br />NOTE: Read Instructions before completing this form. <br /> l3 Card On 51 <br />0UANTITY OR LOADI ~, (4 Card Ony) QUANTITY OR CONC):NTRATION ~NO. FREOUENC SAMPLE <br />PARAMETER 3 <br />(50-67) <br />~ (36-45) (d6-53) (5d-61) EX OF TYPE <br />(32-37) AVERAGE MAXIMUM U MINIMUM AVERAGE MAXIMUM UNITS <br />(6z~6J1 ANALYSIS <br />(64-66) <br />(69-70 <br />L ANIi Gi SE SAMPLE '`•'~ar7 f'r` 1 94) >Q OLV >i=. :.•.v L~.6,1 a:L <br />! <br />VISUAL MEASUREMENT 0 V is <br />d4UOt 1 (i 1 PERMIF i'' .: I.=1 - • C 00 Cpl: ,y,Y / 1SB;~ <br />iFrLUt1iT GHO55 YALUt AEOUIF(fiMENT ~ I1I9`t ~~~~: lC=0 r. ~: 090 l; ~ 411 <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> ~'~ERMIT' ~ ~ ' ~'~ ~a~~ <br /> <br />tiEi]UlEiEMENT <br />:L s.. <br />"r.+. ~ Y;, , <br /> SAMPLE <br /> MEASUREMENT <br /> ~ ~~~ te ~ <br /> AE4UIREfiAEt~kT r;, y <br /> SAMPLE <br /> MEASUREMENT <br /> • PERMIT <br /> <br /> <br />~ <br /> <br />~ <br /> <br />~ .. <br />:s <br />- <br />~~~~` <br />~1 <br /> <br />^ <br /> <br />r ~.. <br />~' <br /> fiEgUIREMENT tr ~~ <br /> SAMPLE <br /> MEASUREMENT <br /> P E3M1T ~ <br /> <br />~ <br /> <br />,' <br />- <br />rr- <br />~" - ~`~ <br />,~~s - . <br />' ' <br /> ti~OEM~NT fi <br /> SAMPLE <br /> MEASUREMENT <br /> `PERM1~. <br />f ri 1 <br />,~ 1341., <br />f >ar ~ ~;~,'s <br />, <br />:~-; <br />~y <br />:. <br /> (?EOU)REfu <br />ENT r ;; , , <br /> SAMPLE <br /> MEASUREMENT <br /> PEf11ti1F ~ ." „~ <br />3 .. <br />~ <br />~: ~ <br /> ,A1=gUIR>:MENT a <br />~„ I- _r <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED AND TELEPIIDNE DATE <br /> AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN; AND BASED ON MV <br /> INOUIflY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING <br /> THE INFORMATION, 1 BELIEVE THE SUBMITTED INFORMATION IS TRUE, <br /> ACCURATE AND COMPLETE. I AM AWARE THAT THERE APE SIGNIFICANT <br /> PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING THE <br />v il/ <br />_ <br /> POSSIBILITY OF FINE AND IMPRISONMENT. SEE 16 U.S.C. 5 1001 AND 3J U.S C. SIGNATURE OF PRINCJ AL EXECUTIVE C/ <br /> <br />TYPED OR PRINTED 5 1319. (PeneRias antler (hese s(etutes maY intrude lines up to f10,000 end or <br />maximum impnsonmerrt of fienreen6months entl 5yeers.) OFFICER OR ALIT RIZED AGENT <br />C DE <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />ISS.LZ!11T PILL tit illIYEC ApU SiITIEA9LE SGLIDS LI!'IT APFLIBC FCR <=IUkFa14HF FnfCIF fYEl7p 7~S b <br />~~°TlLEABLE SOLIDS 17tIT ITAIYEU FuH ~l0YH~246H VBEC7P FYhNT SUUJBCT IC EUhLEG OF tbCCf II 1.A.i. CII E <br />G 1 If • . P <br />EPA Form 3320.1 (OS-95) Previous editions may not be used. ~ ( EPLACES EPA FORM T-40 WHICH MAY NOY'B,E USED.). Q Q E d L/ H 9 C F 2 ~ ~ I EI ~ : PAGE 1 OF <br />