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REP13689
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REP13689
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Entry Properties
Last modified
8/24/2016 11:43:53 PM
Creation date
11/27/2007 1:16:47 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981019
IBM Index Class Name
Report
Doc Date
4/16/1993
Doc Name
1992 ARR EXHIBIT 3 NPDES 1992 QUARTERLY REPORTS
Permit Index Doc Type
ANNUAL RECLAMATION REPORT
Media Type
D
Archive
No
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PERYITTEE NAYEIADDRE55 /lncludr <br />F'rcilirY Name/LOlrrlOn /drf/rrtnrl <br />NAME ~1 L_l .t7i_CIif. 1. CC!9k'.:6Y'_ ___ ___ <br />ADDRESS ~:OLI)'e l'J sl. f'E: __________ <br />-_-__'173 ~:'PATF' I!f 111'JA! ! 1 ___ <br />--_i_c .~~ _~~-__ CG ~i_I (i41 _ <br />FACILITY <br />LOCATION --~-------------- <br />--1 c It i.:fIA1;U c AI'P:Tr::na------- <br />NATIONAL POLLUTANT DISCHARGE ELIMINA I IUN JYSTEM (A'YULJ/ <br />DISCHApOE MONITORING REPORT(DMR/ <br />(I-16) (17-I9/ <br />PERYIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />-FROM _ ~ TO _ , <br />/7471/ /17-Ill l1i-7J/ (76771 !78-79/ /34311 <br />k' - c 1 h A i. OMB No. ZMO-0ODI <br />i~U'illisi. F•i.T:i "1'J liUUv ',~l~rpvdexplreL~p-al <br />:MIhIJR (~UtlR !iw) ~ ;1'~F'A'P <br />NOTE: Read Instructlone before completing thla lorm. <br /> (3 Card Only) pUANTITY OR LOADING /I Ca OnIY/ pUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br />PARAME7Eq' (i6JJl ~ /Jlfil) ~ (38~J1" 1r6J31 /Jr-611 EX DF TYPE <br />(J7-37/ ~ _ AVERAGE ' <br /> <br />. ~' MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />(61-Ai ANALYSIS <br />(61-68/ <br />(6fl-70/ <br />'I ArIL uI~LA S" SAMPLE 14 a; : ::: )'.:. .' <br />~ iY J~:•-:`+ :. ;: ::r4. :I I::: r <br />- <br />L n Il.h I. <br />_ MEASUREMENT I f ~ <br />.Jt.U L U ~I ~. PERMIT O #Yf' C I)-. ~; i5=1' , 4 <br />. <br />rte i'4r ~ rA~ LII}OI}i1%} ;r;_: .. 'Et:KL~ I UAL <br />:~1. 11 ~. h'1' 4't:Q r:i YAL.II i! REQUIREMENT ;; `" ? r- IN51'~ tlY 4 !le=li / <br />, <br />i ' ~;T -. }, VC: ::,:- I a <br /> SAMPLE <br />~ ~ ~~ ~ I <br /> <br />S MEASUREMENT <br />- " '- ~ <br />i ~ I <br />I <br /> ^< PERMIT " <br />N :~ ':.. <br />~ <br />° GT. :I <br />7 .- ~. 5 v ~ <br />! ~ <br />~ ~ <br />O {'A: <br />~ - <br />~' '/ 1 ~ <br />~ <br /> EOUIREMENT ~, P <br />.. 0 <br />~ ~ ~J 4 .. :~ Q <br />~ <br />" . <br />.+. i <br />- ~a2 <br />I' <br />' SAMPLE <br />~ <br />~ <br />~ ~ <br />/ <br />/ <br />~ / <br />/~- <br />~ <br />/~ I <br />r 1' <br />d ~ '~ <br />/ <br />_ <br />~ MEASUREMENT .. •- // <br />.. <br />i <br />(: ' <br />~~ ~ ~ <br />~ i <br /> <br />17 <br /> <br />' <br />r PERMIT 1 <br /> <br />= <br />- <br />Z c•' -. <br />V 4 <br />~ ~ <br />L'. i' la u <br />1T <br />~ <br />c <br />~ <br />_ _ A <br />:3 <br />~ <br />' <br />~ <br />< R <br />' :+e ~ <br /> <br />i wl r . <br />~ <br />- %i ~ <br /> <br />'r <br />C <br />. (:OUIREI~ENT . . <br />4 ~ c ~ <br />.e F7 m . <br />r •~ I <br /> ' SAMPLE ,d ~ ~ ~ ~ <br />'a MEASUREMENT• r" <br />1 _ <br />r ~- <br />- <br /> <br /> <br />'T' <br /> <br />TEOUIREMENT <br />~ A <br />/ <br />~ } <br />O <br />~ . <br /> <br />G <br />~ f [. <br /> <br />~) .. ~: , <br /> <br />'~ C rS <br /> <br />i L"Jn I = <br />_' <br />C <br />r {''. <br /> <br />'. <br />- ~ . <br />! .J ~ <br /> SAMPLE ~ . <br />' MEASUREMENT „1 ~ '_ <br /> PERMIT a r. u ,., J ~ .. ~~ ' ~ - G 3 p, h ~r ~. ~ r I <br />~ .7 ~•• _ O <br />' <br />' ~EOUIREMENTC ~ ~ <br />_ - .. p ., t. ~.. ' ~~ <br />' <br /> 1 <br /> SAMPLE ~ ~ - - <br />~ <br />~ <br />- MEASUREMENT.' .- <br /> <br />• ~ <br />•' <br />I , <br /> <br />~ <br />- ~ <br />I 'r PERMIT LT ' y " <br />~ <br />~ 5 / r ~ ~ ' LY <br />l <br />~ <br />' ~ <br />~ <br />'` <br />b• ~ I J ~ ~- <br />, <br />~ -. ;AEOUIREMENT + ;, <br />~i ~ ~ r ~ n C: ~ '- <br />i <br />~ t <br />'I I ~ ~ 1 <br />. <br /> SAMPLE ~ ~ <br />~ _ <br />' <br />- MEASUREMENT) ~ <br />., ~ - <br />- ~ _ _ ~ <br />~ J.1 PERMIT .y r '1 ? u <br />p ', ,; „' ~~' 1 W ,- i LA• `, r'.~ <br />r J <br /> <br />.I <br />FEDGIREMENT~„ <br />C, ~, <br />U- <br />[: j- m ~ <br />s. ~. <br />- ^ <br />NAME!TITLE PRINCIPAL EXECUTIVE OFFICER I CERTI FY UNDER PENALTY OF LAW THAT I HAVE P ERSONALLY E XAMINED TELEPHONE DATE' <br /> <br /> <br />UN <br />I P <br />' •~~ AND AM FAMILIAR WITH THE INFORMATION SUBMITTE <br />ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATE D HEREIN; AND BASED <br />LY RESPONSIBLE FOR <br />/~/j { <br />~~~ <br /> <br />~ l <br />I.. C;. ATk: <br />iS <br />' <br />~ <br />L ~AFBA <br />i <br />T UOSB~TAINING THE INFORMATION. I BELIEVE THE SUB <br />E <br />A <br />A <br />O MITTED INFORMATION <br />L <br />p , <br />,'/ `L ~ <br />' '`~ ~ _ ~~ 3 3 ~~b24-G4 'U <br />1 14 9L <br />;N <br />/L• LANlI/IiNVLHUNPi <br />A INFORMATION <br />UDNG <br />FOR <br />SUBM <br />TTING FALSE <br />ND <br />`NIFICANT PENA TIES . <br />~- THE POSSIBILITY OF FINE AND IMPPISONMENT. SEE 1B U.S.C. { 1001 AND <br />' .SIGNATURE OF PRINCIPAL EXECUTIVE <br />~~ ~ <br />TYPED OR`PRINTED uP ro J/0,000 <br />JJ U.S.C { 1319. (Psnalrb undrr rhos rrrrure may Inrludr finu <br />ondor maximum lmpironmenrq/brwnn6monrN rnd lYePn.1 OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO DAY <br />GOMMENTAND EXPLANATION OF ANY VIOLATIONS (Rq/enrntr allarrarhmrntr hertJ I <br />/LL ~ GNE'ASf--~FE Fuu 7t; J'1'i, F/ I;. 'i tl !': PEli,M I'f. SE:1fL£Ah[. h: ~ULI:/; •lF ti'[' ., .. ,,~U Ii~:L ONLY if <= 10-YHr >?4-ha' <br />fN l•:VEGT CLni"!::U. fF C1.AIn Ai'E'~tOVF:II .IY +,'C:n, '1:,~ b ih11N LLMIi'r; d([.i. !~~li !:: Art'LiEi/ T+J ltF:k'i1R'1'E:D <br />€PA Fgflh 1~'IMl) I+tvlaw Id done mw b ul)f1d1 " ~ IRE ~CEa PA F RM •111CH MAY NOT BE USED) OF <br />
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