REP43321

• Permit No: C1981019
• IBM Index Class Name: Report
• Doc Date: 2/23/1995
• Doc Name: 1994 ARR EXHIBIT 2 PART 2
• Permit Index Doc Type: ANNUAL RECLAMATION REPORT
• Media Type: D
• Archive: No

PERMITTEE NAME/ADDRESS llnrlode
FarlRty Name/Lou11Bn If dl^femul
NAME '~1_. ,)NYD,. 14 ._'11=+1_•Y _._`_____
ADDRE6f_JLO_N VII y!.'t I• _ ________
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FACILITY ___________________
LOCATpN
4PT!ae R. !t. IISTLTCt••_ Tit~tiTnrr~,•
NATIONAL POLLUTI.NT DISCHARGE ELIMINATION SYSTEM I NI'Ut.) l
DISCHARGE MONITORING RrPORT (11MR1
(1-IM11 (I7-19)
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PERMIT NUMBER oucHAeor NU.eaw
MONITORING PERIOD
YEAR MO DAY YEAR MO DAY
FROM TO
•- I ,/.,
f; n i n •t •J I Form Approved. '
P _ ~ • •• 4 r OMB No. 2040-0004
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(J Card Only) QUANTITY OR LOADING (4 Card Only) QUALITY OR CONCENTRATION .
PARAMETER (46-5J) (541) (J8-4S) (46-57) (54-6/1 NO. FREOUE"CT
~ (AMPLE

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NAME/TITLE PRINCIPAL E%ECUTIVE OFFICER I CERTIFY UNDER PENALTY OF Lqw THAT I HAVE PERK ALLY EXAMINED
AND AM FAMILIAR WIrM THE INFORMATION SUBMITTED HEREIN
AND BATED TELEPHONE D A T E

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ON MY INQUIRY O< THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR
OBTAINING THE INFORMATION. I BELIEVE THE SUBMITTED INFORMATION I$ /' /
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VP LAND NVIRDNMENTALAFFAIRS
TRUE ACCURATE AND COMPLETE I qM AWARE THAT THERE ARE
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SIGNIFIDgNT PENALTIES FCQ SUBMITTING FALSE INFgiMgTION
INCLUpNG _
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THE POSSIBILITY OF FINE 4ND IMPRIyJNMENT SEE IB USC { ICOI AND 61GNATURE OF PRINCIPAL E%ECUTIVE
33 USC 1 1]19 lPenallies unJer Ihar smm~s maY brludr fines uV In
TYPED OA PRINTED J/0/Htl unJ ur rna rimum rmnnsunmrm nl Mbrrn A mumhs anJ 5 /rent OFFICER OR AUTHORIZED AGENT I'KEA` NUMBER TEAR MO DAY
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SPA Form $320.1 (RlV. 9-BB) Ff'BVIOI/S Bdirlpl5 /rlBy /1E usBd. IREPLACE6 EPA FORM T•40 WHIG WMAY NOT BE U6ED.1 , ^ J ~ / 7 1 ^ ,T , , -' S _, PAGE I OF