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PERMRTEE NA RESS~IedxY ferdlry6rWTxm ~~ Y. ~ ~_ -. ~~~~~• _ _i _ HtBMMIW~ ~-_q.- - _ .._N~.p~S11G <br />NAGEE PO~BO$M COAL COMPLN~rn ~. __ -Yi15@Ng9~EYNON1iQFtMIQNEP F~191 ~~~ <br />ADDRESS ROADSIDE CiNE, ~ % S PORTALS <br />P e 0 • BOY 14 3 ~ PERMIT NUMBER DISCHMGE NUMBER <br />PALI$AUE CO 81S2D MONITORING PERIOD <br />FACILITY <br />YEAR MO DAY YEAR MO DAY <br />LOCATION FROM 4 O1 TD O O6 3O <br />A T T h: J U H M A. ^! C Y A N, P H k: 5 Z D E N T r7o-7 n ru-731 lI475/ r76-771 r15-291 130.311 <br />----~+-~ -•-'~OrErL~PProvad <br />POND Z =O [OLOR4 oooa <br />(BURP. YC) ^PP~o~°~ 'u~05-31-88 <br />F - FINpI <br />NI?1pQ <br />'''•• t1U UISCHAdCE ~~ '~`~~° <br />Y NOTE: Reed inetrucUone before-CbTnplBtinp this form. <br />PARAMETER !3 Grd OnlYl QUANTITY OR LOADING !1 Grd Onryl QUANTITY OR CONCENTRATION NQ FREQUENCY SAMPLE <br /> !46531 l5L6Il /38-~51 !46531 15a-8/1 EX T <br /> <br />131-371 ANµYSIS <br />YPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS rs7-ssl lµ681 169-701 <br />LL ARD GREASE SAMPLE .:#a>a#a ( 94) a0aras c;.>r-1#:~ ~a:)aaa <br />V I:iU A L MEASUREMENT <br />04066 1 0 0 PERMIT. ###ID#~ dEpOitT E5=1 eb~~>r# #Y:~C>ZIPO ##tsA#; 1 .¢## EERLY ISUAL <br />cPFLUENT 6ROS5 YALUF REQUIREMENT ti3t0 <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT:1 .:: <br />- <br /> :REQUIREMENT~ ~.i :.._ ~ - ~ <br />~ <br /> SAMPLE <br /> MEASUREMENT <br /> ~~ PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> .~ PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ~ . <br />NAMERITLE PRINCIPAL EXECUTNE OFFICER I CERTI <br />AM FA FY UNDER PENALTY OF L <br />MIUM WITH THE INFO AW THAT I HAVE PERSONALLY EXAMINED MD <br />RMATION SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE <br /> <br />~~I~ <br />a <br />~' MY INQUIRY OF THOSE INDINDUALS IMMEDIATELY RESPONSIBLE FOR <br />OBTNNING THE INFORMATION <br />I BELIEVE THE SUBMITTED INFORMATION IS <br />, <br />, , <br />TRUE <br />ACCUMTE MD COM0.ETE <br />I AM AWME THAT THERE ME <br /> , <br />. <br />SIGNIFICMT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INCLUDING <br />Qn~ , <br />THE POSSIBIUTY OF FINE MD IMPRISONMENT. SEE 18 U.S.C. 1 1001 MD 3J / <br />SIGNATURE OF PRINdPAL EXECUTNE ~ ~r ~~~~ ~ w EM d <br /> u.S.C, f 1 ]1P. !/MWW. ~Mrr tne~ mnma nleY NcMe rww. w ro i IO,OOD <br />TYPED OR PRINTED rld or nrrinunl.WNFYYMfe/MMerremoneha rgeYrvtl OFFICER OR AIITNDRIZED AGENT CODE NUMBER YEAR MO DAy <br />COMMENTS AND EXPLANATION OF Anr vIOLn I wns IRaersncs sn srrscnmenrs oars/ <br />StTTLEAflLE SOLIDS LIflIT APPLIES U6Lf IF <=l0YA,24HR PP,ECIFITATICU FV£NT IS CLAIPEC. PedHIT'fEE hAS <br />bUdllEN OF PAUJF YBEN f!K~UE5TLIYU ;tELIEF FAU11 SETTLEAHLF, SOLICS PAIttAAY LIt`ITATIUDS. <br />EPq Form 3320.1 108.96) Previous editicne may be used. FIREPLACES EPA FORM T40 WHICN MAY NOT BE USED.) Q U F D ~i ~ 9 8 C 2 2 ~-12 5 F. PAGE OF <br />1 <br />+t <br />