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_ ,~, <br />PERMRTEENAME •S(ftfab '.. ~~ ~~!.., ..'L. ~i~L.L:r'~,~i.-.•. . <br />FwiGp Ntrmd44aavvt:_ •rnrl ~ - ='r-'-'ti <br />NAME YLAn..JY COAL CO~~~ NUCLA'~NI~~E ' <br />~-- -1--- <br />ADDRESS 1300 SOUTH YALe __ ~-= ~ _ _ <br />-_-FLAGSTAFF ,_----^~~66~7,__ <br />FACalrr ^-------^~~ :.: <br />LocnnoN =y-~ r' - : --- <br />AT:f.: DE4NIS~5tEYEN90N. PAESIDEH~2 ~~ <br />NATIONAL POLLUTA NARGE ELIMINATION SYSTEM iNPDFS/ " <br />DISCHAR NITORINO REPORT lOMR1 <br />R-16/ - 117-19) <br />000000213 I 001 w <br />PERM17 NUMBER DISCHARGE NUMBER <br />,' tdONITORING PGR!OD <br />• YEAR MO DAY YEAR MO DAY <br />u FRl11A1 a! I ~I `TD! • ~I ••~I ~-1 <br />/141!/ /11.131 11~-IJl !1617/ l18-191 /34311 <br />l; i , <br />F'.-~-FINAL ,/ <br />ACUTE 42T TE5TING FOk OOTFRLL <br />i ' <br />~.r <br />nTN(7H"' (SI1Hk YC)~ ~f1NTAS ' <br />NOTE: Read Inatructlons before eompleting this form. <br /> (3 CaMOrtly/ ~. QUANTITY OR LOADING <br />~ ll Card Only) OUALITV OR CONCENTRATION NO FREQUENCY $AMPlE <br />PARAMETER ~- ~ N6J3J (J~dll ~ (38aJ1 ~ I*6J31 /JI-eil EX OF TYPE <br />_ <br />l31-37J ~ ~ <br />. ~ AVERAGE' • ~ MAXIMUM- <br />- UNITS ~ MINIMUM AVERAGE MAXIMUM UNITS <br />6143 ANALYSIS <br />(61fi81 <br />l69-70) <br />F/F STATkF..UBHA ACU '- SAMPLE .. <br />~ -~".:.T}GGOfi4 <br />' GOOOt'ri <br />- ~ avt-'oc'p <br />` <br />'Ek1UU~.FIiklA_ r . <br />.. <br />MFASUREMENr-, , <br />~-'~'.- - .- - ~ .. 0 - ,- 0 QARL'! _RAi; <br />TGM3U 1 O . O V' =''PERMIT='J~.a C:~ 600,~-~( <br />~ <br />' ~~4u00f6ti0 `" ~'~;~ _ .+~ 9ED,0?}T :x.'~._4~G4 ,;. 8EP0`RT = A55=0 r,~- ITALY , <br />' 'RAB <br />EFFLUEyT GROSS YALU ~EOUIREMNr~ cr._; <br />.}^r <br />p. ;. , r:;:-,~.,5= <br />' ;,$'I; -tiL'SA`IP v",-=..µ• '5 NG AM? 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' _ <br />SAMPLE C N <br />..~ . <br />~ <br />•~ <br />` <br />.. c <br />- <br />.;, ~ <br />- <br />~ <br />~~ _i •~ <br />u <br />- cz -I <br />W. <br />- <br />:j MEASUREMENT`` ~. • <br />y"•.:. ~ ~ <br />.. n ~ <br />? ~ ,! <br />~,` <br />~ Q' .r <br />~ <br />, <br />~ 'x+ , ' ~n ~' /.'7~: r v - <br />~ <br />'•: 't ~ ~ T' <br />~ <br />'~ !!'. V ~ <br />r <br />'h <br />., - - .NEOUIREMENT - <br />, <br />~ <br />. <br />. L:. i4 .p]` <br />~,`.. ~'.e :1i ty . <br />A <br />[: !: qr.r <br />Z <br />` <br />f4.• <br />~ .- _ ~1. rl 4 <br />( <br />. <br />ar <br />O <br /> <br />.v <br />•- ,~ - ~i~ - <br />~- <br />'.: SAMPLE <br />MEASUREMENY~ _ <br />o:N <br /> <br />. <br />~ ~~,..,. .- <br /> <br />c _ - <br /> <br />~ <br />(j <br /> <br />.. <br />- _ __ <br />.• S <br /> <br />~, <br />! r.~ Q <br />La <br />b'J. <br /> <br />r <br /> <br />~ <br /> <br />Dq <br />T <br />.- D". 'u <br />'~~. PERMIE.: <br />E <br />~ _ <br />F i. p. g <br />'~ '' <br />- r <br />~.~1 {~ '-r p <br /> <br />: <br />~~ <br />~ <br />L. ~. -~,t. <br /> <br />• <br />!. ,}.._ <br />~s, v~, y <br />~]~`1 <br />~~' - <br />I. y <br />r <br />I <br /> <br />~ <br />. <br />I1 <br /> EOIafiEM <br />NT <br />•A ~Y. <br />.y y'..y , <br />G <br />"i' Gi' C ~ PI.' :II <br />' <br />~'' <br />S ~ ~ lJ' . <br />' : ,. <br />• <br />_v' ~ 1 <br /> .c . <br />. <br />J :.A <br />- L <br />. 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L <br />'•' ~'~~ C .PERMIT' °G <br />EOUIREMENiCx <br />R '. sJ~i :71. ~ ~ <br />~, 3 ~':y,~. .•U; ~`; a.` <br />~ i~..'id,~: <br />~ - -' ". 3. `t ~e <br />.'.L' .3; Y. <br />' <br />~ v ~:.' ~ <br />l ..i'r'',i.~.'''- :.: i1~, ~' <br />'.~ ~' } <br />' <br />` ~ °~ <br />~ <br />I <br />r^ - ;L rr- ~ .ip ti.:'~', •ta c <br />r tl - - ~.• <br />; Q. er, ;, <br />,, ., _ r I <br />, :I C. p _-1 Y` SAMPLE ..V <br />MEASUREMENT] .Y 'A:.:'C~ ~N s <br />~y <br />7 . ~~~ ,' <br />e. ~ a=. S7 ~, >l ~ <br />_ - i~ 3: ~ <br />y" <br />_ ,~ ., <br /> <br />.... c <br />. P <br />^ <br />i-PERm,i ~ <br />IR <br />UIR <br />T~ <br />:.e.:s:.e- .' r. <br />1[ <br />~' <br />... ~ ., <br />~~~ <br />' <br />' <br />( <br />= <br />'>l <br /> <br />~ <br />.-.~.,~rY..~h <br />.,h <br />~ ~ p <br />-~ . tEn <br />,.:~-. <br />...~ <br />,='w.:: ~L' ~ <br />'F <br />.,._ ...'.~.~_ <br /> <br />- ~~ ~ <br />i' ~ <br />a ~ <br />~ ~C. 1 <br />{ <br />. <br />• <br />.. _, ~ <br />EO <br />EMEN , <br />bi:3 <br />: Q.S, . 1 <br />? <br />. <br />~, -. <br />I <br />, _ ~ <br />J S{r ` D, C, <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER? 1 CERTIF'/'UNDER PENALTY OF UW THAT 1 HAVE P <br />AND AM FAMIOAR M7 <br />H T <br />I <br />F <br />T ERSONALLY E <br />ED %AMINED _ .r ~ TELEPHONE <br />~ <br />~ <br />I ~ DATE <br /> <br /> <br />Brian P: UUljfee -. ~ <br />} T <br />HE <br />N <br />ORMATION SUBMIT <br />HEREIN; AND BARED <br />ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br />ING TH <br />INF <br />T . : <br />~ T; <br />~ <br />r '^' <br />• <br />- <br />\ <br />- <br />'•° AIN <br />OB <br />E <br />ORMATION. I BELIEVE THE SUBMITTED INFORMATION f <br />J ~ <br />, <br />, <br />~ <br />" <br />~ <br />~ <br />l } V <br />- <br />- ~taDa9er j: ~ - -_ =- "'~ <br />~ '' <br />' IS TRUE, ACCURATE AND COMPLETE. 1 AM AWARE THAT THERE.ARE SIO~ <br />NIFICANT PENALTIES FOR SUBMITTING FALSE INPDRMATION, INCLUDIND / <br />_ <br />- <br />~ ~ <br />' <br />- <br />C~ -- - p` <br />74 <br />52S <br />~ <br />L- <br />r~ <br />~ <br /> <br />D7 <br /> <br />7 ~ <br />'~ <br />G <br />n THE POS&BIUTY OF FINE AND IMPRISONMENT. SEE 1B U.S.C. f „1001 AND <br />I <br />S <br />C <br />P <br />' <br />1 <br />' - <br />J <br />ECUTIVE ~ "OZ 7 <br />~~SIGNATURE OF PRINCIPA J <br />_ <br />~ ,U I <br />. <br />. <br />. II <br />71Y. I <br />ININO W1alr IIrOr lrOlYfO rnOY In[rYAf JLb <br />YP'JO 1rP,6W <br />" <br />+- TYPED OR PRINTED aMwrnaaLnarn rmpuwmrnra/6enwrnemonr/aane Jyr.rsl OFFICER OR AUTHORIZED AGENT NUMBER YFAR MO oAr <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS/R~jtnna aaoflarhmenn hrreJ ~ ~ i <br />SEE PART ~I9: OF PEAtyIT FOA'DETAILS OF TEST PAOCEDUAE. AEPOAT AE5ULT5 OF IkC TEST-AS--"lfI~li"U.""." ANU. 50%: <br />•".ORTALITY T3.ST AS "f7AXI'1UNH AND ATTACH ACUTE TOXICITY TEST AEPORT POAtl TO DNR.~''.CCPIES CF A.LL Zr7F0A!^.ATIO+ <br />ly;,- rnR13320.1^ 9. P7BYIOUS adlllOae Tay Da UBBd. (REPLACES EPA FORM T~rO WNICN MAY NOT BE USED.( ~ PAGE OF <br />