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PERMITTEE NAME/ADDRESS lGd~i frd~ryNadGersnm UD~paen/ NAME POFIJF:Rh;i F. !: C11n1 C~Y.~i'd.GY Aooaess kOAUi:IDF :`:.. e , N r, ; f i;;1TA L:i P. u. sux lu3'> PALi:iAD? CU d1S25 FACILITY LOCATION r1TTN3 JOHV A. `;:VAfl, f~:.SLL•NT NATION,~¢¢ sylTll ~ ArLt ISC;MMGE ELIMINATON SYSTElA /Np~,'ESI ~ , ~ ~ ' - FOFp~;APProved. Dl3'6Hk_R6~ON)TDRINO REPORT f~A19RFti~ ~~ 0.2040-0004 t? P011D 6 TC COAL CAel expirse 05-31-88 `. •, ^,, "' "' (SUDN YC) 13345 PERMIT NUMBER D19CXMOE NUMBER F - FIt'AL MONITORING PERIOD YEAR MO DAV YEAR MO DAY FROM g A OLL O TD 9 R fi !262/1 l22-131 III-251 !26271 !I8-191 !3431/ HIkCR ~'~'-'" NO DiSCHARI-E ~~[ ~{:i' NOTE: Reed IneWCllDro before letinp thu loan. PARAMETER l3 Grd OnlYl QUANTITY OR LOADING !1 Grd On/v! QUANTITY OR CONCENTRATION ND RIEOUENCY SAMPLE !46531 1546/1 138-151 !4653 !546/1 GF l31-371 AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX !at-sal MALYSIS !64681 TYPE 164701 F,h SAMPLE a344V# 7#SE+?#a tAK:1 r,D ~ 12) ( - MEASUREMENT ~ Uo4u0 1 o u PERMIT .: ~ i.~::i ~ ~...... ~>aapip~ :: ~ ~ ` : • ' ' 40.OLL#?F . 400 ~, 5 : ~ S ~ , . 9. Q' : ~ ~ EE[(L~ ~$IT I , ~ REQUIREMENT.<. . ... ::: : :.,. ...... . .. ... .. . : : . .~ : ;. . , . N .. ~. :,OLIUS fUTAL F SAMPLE 4#014Ae4 ~ 4014444 b04000 ~ - -~ f ~9~ ~ ~ ' ""~ SU~PhNDF.u MEASUREMENT _ - - ~ '° u0~ r 30 1 0 ~ - PERMIT. .:. .....:. :... ...:.. # ?~?M1Ars:::; .... .. .....: :. .:: ..< . ~'~:. ;`:.'%: ~ soa ~ :.... ~i!C1~~4a9 ~ 95 +'. :., .. •.. . ~ .. 1'{~ , tl~~/: ... R REQUIREMENT ~:.:;c.: ~: ~::;; . >:. -:::..• .,,.. . ... ~0:.lDS, ~frTTLe:AbLt. SAMPLE t~34f:xC >a####~>' 004#O0 -- -- - _ - ( ZS) - MEASUREMENT VOS45 1 ~U U PERMIT .#>¢~,.#-:#::~..: .. $YFY.FgFQ10 4L: t>;!+##1JIS,1 gEFC1A3'. ~~~_~B$:FGRT> INCE! :kAF3 eFFLUhNT 055 Y U• REQUIREMENT 90a ~ 4 .N .. IhUN, TUT'AL SAMPLE #4 p;F;=;- 4C##>k ~Y bt+#1htII ~ 19~ (AS P~) MEASUREMENT LilU45 1 D 0 ~ PERMIT. - :' li###>6~~4.:~: ~44(A1,IilEi.# .:.', #r}G - Rr?}A#/a/S 3'.5~ ~ Ta0 F..~ ~ .~ liCR/ :AAS CF' `S Y REQUIREMENT . ;:, if CAGC ann r. ::* r:: v M r• T , ri Tu LL AMD uREASh' SAMPLE K•maszY# 4#aaoo ##4##~ _ ( 19) MEASUREMENT ~ ..:PERMIT"' q?OIRC144:... .. ~ risxb#417+ 4#~ .. ... t<~ ..: ... LE.~fd:A.~ :: .... ....:. ... '~:8: :.:::... .. .i sOg2iN ;RAH tt'PL T -~" REQUIREMENT: .. •.. .~. .. ..... .: r...~... ~: ;~ :..: ..~... ,.:.:.. oan:F ~.P. . ... ' . ,: •.. ;, ' t T FLOM, IN CONUUI.^ OR SAMPLE ( U3) #•##40 0040q>?• r+g6044 _ I'NHU TREATMF:9T F'LA A4 MEASUREMENT i SUUSO 1 U 0 PERMIT":. kBP q$'f°.. ~ . ~EPa1lS Czr#0>a4 44t#fi10 91#:>@16$SF. ##4 EEY. j,Y 'NSTAN SF'FLUEN? v!;i)::5 VALUE REQUIREMENT. ## SUL1D5, TuTAL SAMPLE a4#aaa aOrxa4a ##aaoo ( 19) GI SSOLV6D MEASUREMENT 70295 1 0 U PERMIT #yt4:iti7eQc..: .!C4RO0sT. 4-Y0 L14¢#04 AEFdA'I :RBf1.ORT. ITRLY >RAb e.PFLUENT Gr70:i5 YALUF REQUIREMENT ppp# T ..M N NAME/TFTLE PRINCIPAL EXECUTIVE OFFICER I cERnFr UNDER PENALTY of uw TNAT I NAVE PEflsoNULr ExAMINEO Mo AM FAMILIM WITH THE INFORMATION SUBMITTED HEREIN; MD BASEO OM TELEPHONE DATE ~/~ ~ ~f% y~ j q / / L~ MY INQUIRY OF TNOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR TAINING THE INFORMATION, I eEUEVE THE SUBMITTED INFORMAnON IS / ~ UE, ACCUMTE MD COMPLETE. I AM AWME THAT THERE ME r SIGNIFICANT PENAln E3 FOR SUBMITING FALSE INFORMATION INCLUDING ~ - . THE POSSIBILITY OF NNE MD IMPNSONMENT SEE 18 U S 1 1001 MD 3J C V . . . . BIONATURE OF PIIINCIPAIE RTE ' U.S.C.I tJtY. /Ar/a.+u.lr rn.~+onnv+m+v hrAd+n++wroSlo,000 TYPED OR PRINTED rW ermuir++n irrAVl+wnwnr eF Mrw++namarN+A,Oa Feva/ OFFlCER OR AUTHORLLED AGENT coDE NUMBER YEAR MO DAy COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference slI atteehmenfs heiel ~L•'TTLEAbLM SOLIDS LZCIT APPLIL5 ONLY IF t=l0YR,24HA PRECIPITATION EVFNT IS CLAICFD. PERgITTF.° HA5 :,URDtN OF' PROOF YNEN NEQUESTING RELIEF FROM SETTLEAt;LE SDLIDS PRIPARY LI!'ITATIOFS. EPA Form 3320.1 108-951 Pravloua edrtlane mey ba used. /REPLACES EPA FORM T-40 WNICN MAY NOT BE USED.1 PAGE OF 00629/99CZ23-1256 1 :.;