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PERMITTEE NAME/ADDRESS (Include FaclliryNmrwlLacanon ijDiffereml NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM MPDES) Fonn Approved. <br />NAME COLOilTO COAL COEFAMY, L. P. DISCHAR GE MONITORING REPORT (DIMR;e) MINOR OMB No. 2040-0004 ' <br /> <br />ADDRESSCOLOYTO dINE <br />000045161 OOY A <br />(SOBR RY) Approval expires 05-31-96 <br />ST 31 STATe tlIGtlY/T 13 PERMIT NUMBER D_ISCHARGENUMRER P - PINAL dOR,AT <br />dEESEY C0 .91641 GULCH A SEDI POND/GOOT SPGS CR <br />FACILITY - ~ MONIT,ORING PERIOD <br /> <br />LOCATION YEAR MO DAYS, ~' YEAR MO DAY <br />Y ~v <br />" <br />rr3 NO DISCHARGE <br />~~~ ~~~ <br /> FROM <br />~ o++ TO ~° ° <br />1 T T N : J . D. N A Rd O Y , GENERAL dA y AG E A t2o-r) (urz3~j..~~(z}zs) (zsz~1 rze-zv) (3wf) NOTE: Read Instruc[lons before completing this form. <br /> (3 Card Ony) QUANTITY OR LOADING (4 Card Ony) QUANTITY OR CONCENTRATION NO. FREOUEN SAMPLE <br />PARAMETER 46-53 (54-61) (3815) ~ 48-53) (54-61) EX OF TYPE <br />(32Jn AVERAGE MAXIMUM UNITS ~ MINIMUM ~ AVERAGE MAXIMUM UNRS <br />rcza3) aNaL~rs <br />(64-68 <br />69-70 <br />uti, wnu tswbw.)6 SAMPLE '~ ~ a YY H~*~ aa~ara 4>f ~^' Ts <br />Y I SU A L MEASUREMENT ~ g;;.;: _ <br />~ ~ <br />84066 1 D 0 <br /> <br />EFFLUEYT GROSS Y6LU1 ~•.~ <br />PERMIT ~; <br />REQUIREMENT T <br />~~ <br />=: ~ ~?"~ T <br />,:~{~~~yl <br />?~~ <br />1 <br />~° <br />~1O-O a;)q <br />~''§- <br />a ~ ~ rr <br />~`r 3 ;. <br />a~ ~ .ww^ ##'~ <br /> <br />~#~~ t' <br />^A -s <br />,~': <br />~ <br />~ ~r`~ti <br />r• <br />_~~~~. ud= <br />SAMPLE <br />SAMPLE <br />r <br />SAMPLE <br />}'. I y± <br />SAMPLE <br />MEASUREMENT <br />~„fl5. PERMIT,:.' <br />~REGUIREMENT ;~ _. .... - <br />SAMPLE <br />'~: u~. ~` ~~ k € "~ ; .3 xl " ~ s ~i'c^~ ~_ ~" s~' '!` +~~ a i .,y ~~, <br />s <br />SAMPLE <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />TELEPHONE .I 'DATE <br /> INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPON <br />THE INFORMATION <br />1 BELIEVE THE SUBMITTED IN SIBLE FOR OBTAINING <br />FORMATION IS TRUE !l <br />{/J/t ~ ~ M <br />(~W//e~^ ~ ~ <br /> , <br />ACCURATE AND COMPLETE. I AM AWARE THAT TH , <br />ERE ARE SIGNIFICANT . <br />. <br />J/ <br /> \ ' I <br />U~ NO-/YV~O PENALTIES FOR SUBMITTING FALSE INFORMATION. INCLUDING THE <br />POSSIBILfiY OF FINE AND IMPRISONMEM. BEE le U.S.C. § 1001 AND 33 U.S.C. <br />$1~ <br />TURE OF PRINCIPAL EXECUTIVE /r~~ <br />-170 /~ 'I <br />T127 ~ ~IoGD p/~ <br />! 1 <br />IO <br />~S <br /> <br />TYPED OR PRINTED § 1319. (PeneMies under Ihese emnrtes may Inclutle lines up ro ff0,000 end d <br />medmum impdsonment of beMeenBmonths endslaen.) ~FICER OR AUTHORIZED AGENT <br />E <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Aelerence ell attachments here) <br />SETTLEABLE SOLIDS LIdIT APPLIES OYLT IF <=lOTA,24RR PRECIP EY.P.RT IS CLAIdED. IF CLAN APPAOYED BT YQCD, <br />TSS E IBDY LIlIITS YILL NDT BE APPLIED TO 9EPORTED dEASUREtfEATS - SEE I.A.2, PG. 5 POR BUADEY OF PROOF <br />R R'IItTP RM>?YTC lITT t rV VJICV - T t1 /~ or G '~omn,r• c.rnTrur T ...~ 3 <br />y~..nnr`w rnuc _ • n e <br />7 <br />EPA Form 3320.1 (08-95) Previous editions may not be used. (REPLACES EPA FORM TdO WHICH MAY NOT BE USED.) <br />QOQ~~f 99 9 ~9'S+3,QS7 PAGE <br />2 OF <br /> <br />