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Form Approved. <br />PERMITTEE NAME/ADDRESS (Indrir Fa•Wq Nw/Lerr+ow (/D(0'wmuj NATIONAL POLIUT ANT OISCN AAOE EIIMINATiON SYSTEM ((NPDESI OMB NO. 2040.0004 <br />NAME ~ i''~ ' , . DISCHARGE MONITORING REPORT ~DMRI - <br />ADDRESS " -';L~ll~t_ C,r1i~I':'UN MINL ;UUk u:~l i <br />' 0. BOX 9Q PERMIT NUMBER ascluwoENUMeE>, - r ?'•:;/'~L Gf~FLD <br />r~lA .. • '•> '_ ~ ~•4:= Ttl E SALT CN . <br />MONITORING PERIOD <br />FACILITY C(:t_ANE CANYpN f"Il i`:'- YEAR MO DAY YEAR MO 0 Y • ~/ <br />LOCATION L l7MA FROM TO ; <. Ate- , <br />WALTER WH I T~.EDCy1=r i`t i IVr i~i ~_ NOTE: Reid k+~huedorn beitxe compl~tlny thM fwm. <br /> <br />PARAMETER <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. FREQUENCY <br />SAMPLE <br /> of <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX µ'''EY~e TYPE <br /> SAMPLE n :_ <br /> MEASUREMENT <br /> <br /> PERMIT , .: •tt ~ i#s.~•;I. ;; •s; ~ ~ `~. (.i ti f,lr.• i, <br />!t:l!1 ~>!~`)~=,-; ••.'+,~ :: REQUIREMENT I;: MINTMUf1 MAXIMUf'i <br /> SAMPLE - , <br />j-;,. ~ d;;; MEASUREMENT <br />:~C15;.itJ 1 _ _ PERMIT •tr#*r ,:•~• ~.##•sl~i~if ~t ~=###=i , . ,r •_ • 1," f : -.t..:, <br />F~FLU1*N( Vr ;~~_ .REQUIREMENT r' r ti- -•+ <br />{ ~ ~ '-! SAMPLE <br />~.riS MEASUREMENT <br />C! ! ,r4'.. i PERMIT ##it"it~s+ _. _ - ;~# #3P*# . ~~ V ..,~.... GI'A <br />F.'r i LU1=.NT t~kt'_:.` ~ REQUIREMENT _-;C}j'}r~, lrlt/C; i <br />)A1L`~ Mk + : <br />~ r1GNTt- <br /> . _ <br />. <br />L I` i-s` i SAMPLE . ' .~ _ i. <br /> MEASUREMENT <br />_, PERMIT ~t~s•1E~,r~~ a #-stiliP## ~-+ n;;##tfil• ##•3s•#-IF~It I 1 E',~:; <br />;~7v~-,~; ~~~ REQUIREMENT ~ .. ^•IS1 i'iAX i°i:,. -~!~!T <br />::+,'. U 1 SAMPLE r <br />., :?. ~-t T i''.NT F: MEASUREMENT <br />`50 ~ G d PERMIT R - iR ~ I-!I_PGRI ~ ,kx# ###~# 4F at#~•### -:; ,~ :; ,;-. ., 1. • ' ! '. •(A <br />-U~t~IT G'~i)55 ~..' REQUIREMENT }rii:}pi L:AILY NiX. <br />,i... .. <br />'F A`.;E SAMPLE :~ . . <br />:UAL MEASUREMENT <br />'~•f•~ 1 Cr PERMIT .+:.~-r~. ~l~i(~ ~ ¢: ~+ - . r ..h ~ ;r-~. <br />~.~~ ~ ';~~'_, REQUIREMENT ply.: <br />_._. <br /> SAMPLE <br /> MEASUREMENT <br />'PERMIT <br />REQUIREMENT <br />NAME/T1TLE PRINCIPAL EXECUTIVE OFFICER ' ^e^"~ " r pen. t~ or lew Ihet thh docvtnent end ell ^tlKhmmis .ere TELEPHONE DATE <br />prepfred under m~ direerbn « apmflon In Kcord.nce wish . s~Nem del[ned <br />_ to ataure IAN ~uetlned personnel Pr~A7 plher .nd eeNuNe the InfermNlon <br />.-`-, . ~ ~,: ~ ' wtbmltted. bred en mr tnqulry of 1M person «persoro wM mon.[e the system, - ~ - Gy j <br />dl <br />ty <br />) <br />~,-- <br />lh <br />lbk r <br />f <br />- <br />~- <br />« <br />ose penero <br />rer <br />respon <br />« pther+n[ the Inrotsrotlon, the Inrormouon <br />, <br />t wbmlged b~ to the bt~t of my tnewkd[e .nd belhr <br />lrve <br />.[cYnte <br />M <br />m <br />--_~ -- <br />' <br />kl <br />` ~ <br />~ r <br />:' __ <br />~ <br />, <br />. <br />.. <br />co <br />p <br />e. <br />y <br />~ <br />~; <br />/ <br />- <br />• I -- I .m .were tAN IhfR .re s1[nllklwl preNttes rOr subml/tln[ hl: In(ontrtlon <br />eI ATURE Q!F /RINCIPAL EXECUTIVE ; : <br />/~ <br /> . <br />I1M <br />df <br />th <br />ltlt <br />! n <br />d l <br />A <br />d <br />PED ~ pR~~p u <br />n[ <br />e pos <br />n..n <br />b <br />y o <br />~np <br />wnmem r« tnowln[ .ielNbrvL OFFFCER OII AUTHORIZED AGENT COQ NUMBER YEAR MO OAY <br />CaMMEN I S ANU [nrv.rsn ~ w.. yr rn.. . ~v~....vn.a rnwrwrmr:w srr wrrwa.ronwnu nwrq <br />.:-~ ~-!;~ ~ ~IOD REPORTED. DIL gt GREASI_ -- SEE I. B. 1. C. TD5 I`1C <br />EPA Form 3320-1 (Rev. 3199) Previtws editions rmy be used. nn~gF, 1 1L5 iS 3 4-pact fgFtp. PAGE OF <br />