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PERMITTEE NAME/ADDRESS (lnflude <br />F~rlllry Name/Loc.tlon if tliffen:m) <br />NAME _~I.OY-Y-0 -COAL -C O-ARAN Y- - - - - - - - - <br />s.DD~~OIAILY.O-.e1S.NE ------------- <br />,-- - _ 573.15-T-T~ Ji LG H-YAK-1.3 - - - - - - - - <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPUtS) <br />DISCHARGE MONITORING REPORT (DMR1 <br />(zdb) rn-!9) MINOR <br />(SU6p NY) <br />PERMIT NUMBER Dl.fgwwcE wu"srw F - FINAL <br />frp(}q.l~roved. <br />OMB No. 2040.0004 <br />---G-Gi.llt'0."---------~'v"LA4+'-- MONITORING PERIOD YEST PIT SE'JL'"P'D""Y'~"'!"A'YL'l7R CRK <br />FACILRY ___________ <br />YEAR MO DAY YEAR MO DAY <br />_ <br />LDOATON ___________________ FROM 911 U7 l?1 TO J4 IJr) 3D tp{1lA NO DI~CpARftF ~ ( '~~~% <br />' S l10-II) (11-1J) (14-15) (16-17) l18-19/ IJO-JI) N07E: RBed InBtfUOt~OnB DB}Or IlYnpleting this IDrm. <br /> (J Grd Only) QUANTITY OR LOADING (4 Card Only) QUALITY OR CONCENTRATION <br />PARAMETER, (46-SJ) (541) (J8-45 <br />(4d-SJl fJ4~lI FgEWENCr <br />aP <br />ST <br /> <br />(J1-J9) EX <br />ANALYSIS PE <br /> AVERAGE MA%IMUM UNITS MINIMUM AVERAGE MA%IMUM UN17S (B1-0)1 (64-0!) l69-]nl <br />IL AMD GREASE SAMPLE =!A##fsb ( 94) r#+zrA+pYA t<V k~40 aeabltrb <br />I S U A L MEASUREMENT <br />4066 1 0 O PERMIT ###### 3 Y ES=1 ####+~# ###### ##4### aan EEKLy I5URI <br />- REQUIREMENT <br /> h <br /> SAMPLE <br />I MEASUREMENT <br />t <br /> PERMIT <br />' - <br />.. <br /> REQWREMENT ~ :. <br /> 6AMPLE <br /> MEASUREMENT <br />• PERMIT <br /> WEQUIREMENT <br /> <br />~ ~ SAMPLE <br />. MEASUREMENT <br /> PERMIT - <br />. <br />• REQUIREMENT ~ '•' <br /> <br />• SAMPLE <br />i <br />1 MEASUREMENT <br />_ <br />T <br />PERMIT <br />~ <br />.~ <br />I' <br />? <br /> REQUIREMENT ' <br /> SAMPLE - <br />~ MEASUREMENT <br />. :. - PERMIT ': <br /> REQUIREMENT ~ ~ ~ - ~. <br /> SAMPLE <br />- MEASUREMENT <br /> ~ <br /> PERMIT ~ !• ' i• <br />. REQUIREMENT ~ i~ <br />`i <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I cERnFV UNDER PENALTY of LAw THAT I HAVE PERSONALLY Ex AMINED TELEPHONE D A T E <br />! <br />/ <br />~ AND AM FAMLIAR WITH THE INFORMATION SUBMITTED HEREIN: AND BASED <br />~ <br />( <br />•..6! ATkINSON ON MY INOURY OF T1WSE NDVIDUALS MMECIATELY RESPONSBLE FOR <br />OBTAINNG THE INFORMATION. I BELIEVE THE SUBMITTED WFORMATKIN IS <br />~ <br />3~~814.4451 <br />94 <br />!0 <br />~ <br /> <br />IIPLAND <br />FfiMR <br />N <br />Y <br />~Nfp TRUE ACCURATE AND COMPLETE I AM AWARE THAT THERE ARE <br />SIGMFICANT PENALTES FOR SUBMITTING FALSE INFpRMATION INCWDVX <br />~ ' 1 <br />/ <br />O <br />I <br />I <br />LAFfAIAS THE P0551B1ITY aF FINE AND IMPinSONMENr SEE IB USC. / loos AND <br />1 13 <br />33 U <br />ft <br />R <br />i <br />d gIGNATURE OF PRINCIPAL EXECUTIVE <br /> <br />TTPED OR PRINTED 19 ( <br />n.n <br />es un <br />er Mcse srrmrcs may mNV <br />SC <br />e rrbn u0 !o <br />!/OfXVI eM or m,simum imprisanmml of 6ervmn 6 months ,nq S years) <br />OFFICER OR AUTHORIZED AQENT AREA <br />NUMBER <br />YEAR <br />MO <br />D< <br />r ~.VmPlcnl wnv sawrLwnnnun alr nnr vlvLnllvna 11serc¢nce .u luacnmMls nere) <br />! ~ <br />SETTLEABLE SOLI05 LIMIT APPLIES ONLY IF <= 10-Yfl, 24-HR PR@CIP F.VENT IS CLAIMP.D. IF CLAIM APP ROY ED dY <br />f YOCD, TSS~„~ IRON LIMITS PILL NOT BE APPLIED TU REPORTED ?iP.ASUREI!ENTS--SEE I.B.lA, PG U AND I.B.1D, PG II. <br />Form 3320r~f-. ' Y. g•BB) PhBV1q/S EUIf%OIIS T8y IJB 4SBd. ~ (REPLACES EPA <br />MAY NO7 BE USED! <br />00008/931109-1331 <br />OF <br />2 <br />