Laserfiche WebLink
PERMETTEE NAME/ADDRESS 0ne-i6irdlryN../la.non dDb...n0 <br />NAME POYDEAHJttA COAL COPIPANI( <br />ADDRESS NUADSIDE ,^„Y~'~ \ !; 'i DOn TAI,.; <br />PALLSAD~: CJ ~1~2~ <br />FACILITY <br />LOCATION <br />r.1'7H: JJHe A. .".CNdUr r:.c:iILF.'iT <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM U it L U 1 TO <br />170-1 /1 !II-231 l1~-I61 1I6-771 178-?9) !JO-3E1 <br />. ~ . ,. <br />err` ~ i~>".~r~t_ y <br />F - FIlAL <br />Mltr[~Ft ,':t <br />,~' <br />NOTE: Reed InetrucUaru before eomplulnp thu form. ' ,~ j I <br />I <br />PARAMETER !3 Grd Onlyl QUANTITY OR LOADING !1 Grd On/Yl QUANTITY OR CONCENTRATION ~ NO, FREDUENtY SAMPLE <br /> 1e6-631 15461 /38J5 !46531 154611 y~ <br />I37-371 EX Njl <br />g5 TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS is7-sal -16~-881 163)01 <br />LC U STAiHt 4HHR AC SAMPLE :+=##.;. Ci=O##0 #y'.t~}## #.".v.Y,+,yt ( 23) i . <br /> <br />Cd3I0UANHNIA <br />MEASUREMENT <br />>~~V <br />d <br />'/ '0 y <br />Gl4 <br />1'A t13 t1 1 (. 0 ~, ~,• ^- PERMIT. ;t#~~pt##~ .. ..valAr~9.'--,`. b## tii1~..DQ~01 ~ a±cr>o-aiik# ~ #x~:a ~~#u. ER- ~ ~2H•LI tBAE <br />oFFLUtt:[' GHUSS YklO REQUIREMENT <br /> <br />.. <br />,: <br />. . #tAk# '~~ .Y.JILDE <br /> <br />.. E <br /> <br />..~, <br /> <br />:~ <br />. . <br />LC ~U SI AT{i F. 96811 AC ~ SAMPLE a;::p 31C3 <br />~ ##301## 7~a ~ #.Y?##;: #:##4# ( 23~ ` <br />L <br />P1:`IEPHAL_.S MEASUREMENT - .. ~~ O G~ <br /> <br />~i A :i 6 C 1 U 0 <br />PERMIL:::::;:; <br />:: »0;191>d~i+pi ~ ~.: <br />;:..:.~ <br />":: ~~a ~.. <br />;Qt}~: #+-O+q *:: . :x~?~+C~1C~t`;. !R- <br /> <br />;. <br />„[ XALY . .&k® <br />'FFLUENT GROSS Vf,1.U REQUIREtyIEyT? <br />;.;.:. '~ '<'•.;'...;'';' ,, <br />..:;>.::,.::: <br />:;,:,,;..~;-;:;,:,:r.~:.::s iA#i ,.. <br />I::A SAMPLE <br />~~,:~ MEASUREMENT - <br />~ <br /> .~~.. <br />..~PERMIT ~ .; ~ .. ~: <br /> . <br />~REQUIREMENT~ ~ _ .:~~ ~: ,t. .~~. . <br />~ ~~ <br /> SAMPLE ~#. ' <br /> MEASUREMENT <br /> <br /> O IREMENT <br />s~::: <br /> SAMPLE <br /> MEASUREMENT <br /> ~~~:~:RERMIT;~t ~:~ ~:~~ - ~ - ~ - ~ - . <br /> REQUIRENIE~JT~:: <br />~~ <br />~ .:.a. ~ ~ ~ ~ ~ ~ - <br /> SAMPLE '~I <br /> MEASUREMENT <br /> PERMIT':`. <br /> ~REQUIRENIENT <br />~~ ~ .~ <br /> SAMPLE <br /> MEASUREMENT - <br /> .~ .PERMIT::<.~ ~ ~ ~ ~ ~ .1 <br />• REUUIRE.IutElyT' <br />~ ' <br />~ <br />NAMERITLE PRINCIPAL EXECUTIVE OFFICER I cERnFr <br />urIDER PENALTr of uw THAT 1 NAVE PERSONAUr ExAMINED AND TELEPHONE DATE <br /> AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN: AND BASED ON <br /> MY INQUIRY OF THOSE INDINDUALS IMMEDIATELY RESPONSIBLE FOR <br />c e <br />~ <br />E <br />S EVE <br />E <br />I <br />F <br />S <br />E <br />~ <br />NI <br />A <br />U <br />O <br />• <br />• <br />tOVeF . <br />AM <br />TN <br />AT TNERE <br />A000MTE <br />AND <br />COMPLET <br />E <br />AWME <br />ARE <br />RUE, <br />SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INCLUDING <br />' <br />Agent , <br />THE POSSIBILITY OF RNE AND IMPNSONMENT. SEE to U.S.C. 1 1001 AND ]] <br />EIONATURE OF PRINCIPAL E7tECUTIVE 97 245-4101 DD 10 U2 <br /> U.S.C. f 131e. /MM1r. ulAr rMw .hNh+ mry Nchw rw. W ro S 10,000 <br />TYPED OR PRINTED wrnNVl+..n lmFrlrmwrtNNwrnemmNawbreva/ OFFlCER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAV <br />COMMENTS AND E%PLANATION OF ANY VIOLATIONS (Re/arence s/l sftschmenH here) - <br />.;td PAkT I. B.4 F'nR GEIAIL[i OF TE5T PkOCEDUAE. RPT L07e,ST DILUTIOR (~EFPLU}.'.NT) YHICfi IS LETHAL T[) SG;, CF <br />tt.i~ OH„ANIS!1ti (LC ;J) •. A'iTACH ACUTE: POXICITT TEST itEPOHT F^AH TO DtlR. CCPIP.S CF ALL INFO HOST 6E SEAT <br />T(1 rD ~;fN TTT: cB rr iC n• r r•.1 •Cr~ r r n rent n ~ nn wrn <br />EPA Form 3320-1 (08.96) Previous editions may be used. 1 EPLACE6 EPA FO M T-40 NI Ff MAY O ~BE 6 -1 0 0 z U 7 / 9 8 C 2 2 3-1 2 5 6 P -- 1OF- <br /> <br />