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PERMRTEE NAME/AppRESS pwetrr FwrlMryXw/[etr,at y[1(OG.wr)
<br />NAME
<br />Qox sus
<br />=f~SET CE"i 81434
<br />FACILITY ;ORN CRK & ELK CRK MINES
<br />LocATaN -=1?SET CC+ f31434
<br />.1ES T. COOPER, EXEC V. P.
<br />NA71oNK VOIIUTANT dSCNAROE ELIMINATION SYSTEM //NPDES/
<br />DISCHARGE MONITORING REPORT /DMR/
<br />PERMIT NUMBER ascHM6E NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM TO
<br />Form Approved.
<br />OM8 No. 2040-0004
<br />aI:DIPT%NT PO!'~!D I C3 HUT3IIARD Ci
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<br />NOTE: R~~d Irwtrvctlom b~1w~ Eompbth+p this form.
<br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NQ, FREOUfNCY SAMPLE
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<br />EX OF
<br /> ~NAtYSts TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
<br /> SAMPLE - -
<br /> MEASUREMENT
<br /> PERMIT ~: >:-##•li•# _~. ~, r b - C) i.
<br /> REQUIREMENT f"? i I'•.1.'; _.:•, t"~AX IIMUM I"f~~N
<br /> SAMPLE
<br /> MEASUREMENT
<br /> PERMIT t~tt-~•#~;•# zx•ttst.^. : ''? ....
<br /> REQUIREMENT .. i"` •' .- i"C,i i I
<br /> SAMPLE
<br /> MEASUREMENT
<br /> PERMIT - -. .. ##i8•tE#t- - ~~-•~;bif•.a I?~ t-2 ~-'l)~ .~ ~ L, :.~
<br />' - REQUIREMENT :.3UG1a A',It~ D>/i T 1,. 1' MX I`(C:i~:l ,.
<br /> SAMPLE
<br /> MEASUREMENT
<br /> PERMIT #•!f•it#» #iEit### iri~at#i*# ,0c~ 1C)t~0 IVCc~/ F,i?
<br /> REQUIREMENT ::•rJI~A A',l~> ~ ~tiIL.Y P'4X ~ MGN~1
<br /> SAMPLE
<br /> MEASUREMENT
<br />=^ PERMIT ~ z#~~# E•##~ •.z r x## ~~•##at# ? ~~1 .t.1;,'• ; ~ - , ;:
<br /> REQUIREMENT ? hi 5'f Mt? X F:
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<br /> SAMPLE
<br />,~ ! r : MEASUREMENT
<br />r1 PERMIT i?F C!i., r >?EPGIRT ~ - ~•~ ?: ,.
<br />, REQUIREMENTC 3QDA r ,SLY MX
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<br />~~I_ SAMPLE - ~
<br /> MEASUREMENT
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<br />NAME/TI71E PRINCIPAL EXECUTNE OfF1CER + ``Wiry • t~ pena i~ 0 1,w ln,I thh documcnl ,nd ,H •n,~nrnenu ate TELEPHONE DATE
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<br />iIONATURE OF -RINCKAL EXECUTIVE '
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<br />nne,rd tmpnx.nment r~r ~nn.i~.[ .tei,0otn OFiICER 011 AUTMORI2ED AGENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /R~/~rinc~ aN ~ttachm~nts h~r~)
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<br />EPA Form 3320-1 (Rev. 3.99) Prewous edlttorls may be used. .~ ~ ~ •- ~ Tti1S IS 3 4-~It ~Orlil PAGE OF
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