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REP40631
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REP40631
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Entry Properties
Last modified
8/25/2016 12:33:16 AM
Creation date
11/27/2007 8:47:23 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1978091UG
IBM Index Class Name
Report
Doc Date
9/13/1994
Doc Name
AUTHORIZATION TO SIGN PROCESS WATER AND STORMWATER DISCHARGES FROM HARDROCK MINING AND/OR MILLING FA
From
LKA INTL INC
To
GOLDON WONDER MINING LLC
Media Type
D
Archive
No
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EPA ID NumW r (copy hom Ihrm I al form 1) • <br />Cnnllnrrnel lrnrn Penn 7 <br /> <br />AB,C, l D: Saa Instructlotn Glwa prooe^tlinp. Compl^ts on^ wt or tabbc for ^^ch oudall. Mnouu th^ oudall numWr in th^ space provid^d. <br />Tmla^ VI V148, ^nd VII-C ^ra inUutled on ce er^te ^h^ets numbar^d VI41 antl VII.2. <br />E: Polentlal dscharyes nol covered Dy analysis - is any tout polluranl haled in table 2F-2. 2F3 or 2F-4, a substance w a componant of a substance <br />wl^Ut you wnently use or manufacture as an intermarLate or final poduct or byprotluct? <br />Yas ^t all such /unnh babes No b Saedon <br /> <br />Do you Mva any knawlatlp^ w reawn to Wliaw treat any biolopiul uet Iw ^cut^ or chronic bxiciry has b^en m^tls on ^ny of your dieeAup^s or <br />Ori a r^oairtnp waur M notion t0 your dicchuya wiNin Ns last 9 y^uc9 <br />Vu laf all sucA Iluranfs Debw No o to Section <br /> <br />Were any of the analysts reported n roam VII penormaC by a oonaact laboratory w consul6np firm? <br />© Yas plat tln name, address, and e^Mphona numWr d, and polu4nts ~ No (po b Sacbon X) <br />A alma B. Adtlne^ C. Arn Cod^ 6 Phom No. D. Polluunte Mat ^d <br />SKYLINE LABS, INC. 12090 W 50th PL 303-424-7718 Fe, Mn, As, C <br /> WHEAT RIDGE, CO r, Cu, Pb, Hg <br /> 80033 g, Zn <br />1 certify under penalty of law that this document and all attachments were prepared under nN direction or <br />supervision !n accordance with a system designed to assure that qualified personnel property gather and evaluate <br />the Inlorma0on submitted. Based on my Inquiry of the person or persons who menage the system or those persons <br />directly responsible for gatfte:ring the Information, the information submitted is, to the best o/ my knowledge and <br />t.~liel, true, accurate, end complete. I am aware that there are signi(icent penalties for submining false information, <br />utdudiny fha possibiilry o! tote end imprisonment for knowing violations. <br />t. rgrM 6 Oflra^1 Tnl^ (ryp of pnnrJ B. N^^ Cotle Intl Pnon^ tJO. <br />I:trn.rnrf D. coLr,rNS r,E 303-944-2923 <br />L :wynuw^ D Dsu Sprod <br />.~ <br />," <br />i <br /> <br />~ J - `/'/ <br /> <br />P.. . l r~ '~ <br />
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