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pERMITiEE NAME/ADDRESS prbLS'sWyNaWCxulm{rD1As~nA ~-~- - <br />HAME POYUIiRH011M COAL.COHiIRI '-'~-"'_ ~_ <br />ADDRESS ROAD=sI DE HIND, N 6 S PORTA LSD <br />P.U. DOX 1430 <br />PALI3ADd <br />CJ H15?.o <br />FACILITY <br />LOCATION <br />.+'T'TA: JUHN A. ~1CNA8, PiiESICEN'[ <br />MONRORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM V U U - TO ~ ! <br />!1411/ l11-131 111-151 !16171 l16-191 !34311 <br />-sa-r~,t .-.~T~.-..-- ,r,:.~[A-6PP-i~otfYed. ~L' _ <br />~ti~t ~ ~L~"L'~~'3~J'T- P va a p~Pi~5737 98. <br />(SUER NC) ~~.~~~ <br />F - PI FAL <br />('INCA <br />+•~~= NO DISCHARGE ~__~ v+-~ <br />NOTE: Reed IneVUCUors belore completing this form. <br />j_i <br />PARAMETER 13 Grd Onlyl QUANTITY OR LOADING !I Grd OnIY! QUANTITY OR CONCENTRATION NO. mEDUENCV SAMPLE <br /> 146531 154-6I1 I38J51 !1653 !54511 EX K~ 'TYPE <br />!3137/ M <br />y~S <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ref-F31 !54687 159-701 <br />LC 3U :3 ALrtE 4 HP. ACL SAMPLE fi#914t-; #::#:4,? ~ qq~~ ':t#p~~? ,•;~.;::}r} ( 23) ~( ~ <br />/ Q <br /> MEASUREMENT ~~[)O/J Y O ~Ie <br />C,3i~DAPHhZA ! <br />A:i.ib I 0 U ~ .~PERNIIT: .~~: <br />,. O####~~ ~ .#xX 'ti,F### 4',t'.= ~ 00 .fl~fl:II2 ~~ ~?~~~~# ::..~~t#rR~.~ 16R- ~~ :T RL`~`~ ,Rk~g <br />~Fi'I.UENT GROSS VALU cREnUIRE}AEN.T: :. ~~ .....: ....: ~~~. : y:rg !lH..Yk:LU:15~. ~~ ~~~ ~~ ~ ~ T <br />, <br />.. `:'~~ ;i'L'A'T 1lE 96HR AC SAMPLE ~+~C ~Y# A##6ii# .Aq##04 L`:#040 ( 23) „ <br />ri'IFsPHALbS MEASUREMENT ~ <br />~~Op v /~J <br />Y"' (~ <br />~L <br />. n.vDC 1 0 0 .:..:::;; PERMIT... ~;~ fi~Y#-F ~~ .~~ ~ .~##OI±OI?R:#:~ . _ ##~ i.QI).. E1B0~. :: '~ ~>~#ip~IC./l ~.. <br />~ :; :`.~#~•x?C!~?R.':':~ $R- - .x ;~:~~~ :R~kE .~ <br />tFFLUENT GROSS YALU REQUIREMENT ~ ~~~. #OV3 {q ~.~1fkX,q~E . <br />' :'~ CR <br /> SAMPLE <br /> MEASUREMENT <br /> :PERMIT <br /> REQUIREMENT ~ ~ ~~ ~ '~ <br /> SAMPLE <br /> MEASUREMENT <br /> .: PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> ~~ PERMIT ~. ~ ~ .: .~.. . , <br />~ .. ~ ~. ..~.. .. <br /> .REQUIREMENT ~ ~ ~ - <br />,.... <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT . ~ - ~ ~ ~ ~-. .. - <br /> :REQUIREMENT ~ ~ ~ ~ - <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ~ ~ ~ - ~ ~ ~ ~ ~ ~ - <br /> ~REQUIREMENT:~ ~. <br />~ <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I cERTI <br />AM FA uNDER PENN.Tr of LAw TNA71 NAVE PERSOxALLY ExAMINEO MD <br />fY <br />MILIM WITH THE INFORMATION SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE <br />~p~ <br />. Cri ~ MY INDUIRY OF TNOSE INDINDUN.S IMMEDIATELY RESPONSIBLE FOR <br />OBTNNING THE INFORMATION, I eEUEVE THE SUBMITTED INFORMATION IS <br /> <br />~ TRUE, ACCUMTE MD COMRETE. I AM AWME THAT THERE ME <br />INCLUDING <br />TIES fOR SUBMITTING FN <br />SE INFORMATION <br />SIGNIRCANT PFNN <br />~ <br /> <br />~~ ~ , <br />, <br />. <br />EE 1B <br />1 1001 MD 33 <br />P <br />T <br />S <br />C <br />~ ~ <br />~Dl <br />00 f' <br />tl ~ <br /> THE POSSIBILITY Of RNE MD IM <br />RISONMEN <br />. S <br />U. <br />. <br />. BIONATURE OF PRINCIPAL EXECUTIVE ~ 0 <br /> U.S.C. 1 t 31 e. /MMM. uW eww .bOnv. nvr NCM1AI IYn.. W ro t 10,000 <br />TYPED OR PRINTED uN nmuinun irplcmwnrbMerwl6 menela rW6yWa.1 OfRCER OR AUfyIORRED AGENT LODE HUMBER YEAR MO DAV <br />r. <br />e,' <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Re/erencs sll sttechments here) <br />~t:E PAiLT 1.6.u FOR DETAILS OF TEST PHOCEDURL'. dPT LU Hr;ST DILUTION (Z}FF LIIE N?) WHICH IS LeTHAL 'T i; SV: OF <br />,r;:;T O(aGANI5h5 (LCSU) ~ ATTACH ACU'Pi; TOXICITY TEST REPORT FORD TO DH!?. COPIES CF ALL I9FU MUST F~ _F.KT <br />:.I ~'G LF RT "T SrY fi C M'T rr ~TC n c n rt flTertT7 n 'I Tn n m m +n ~m• <br />EPA Form 3320.1 108-951 Previous editions may be uead. (REPLACES EPA FORM T40 WNICH MAV NOT BE US D.1 IIU 29 fi/ 9 9 G 22 3-1256 PAGE L <br /> <br />