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PERMITTEE NAME/AODRESS (Iwrwel.AltryN~/L«rlaw 1/DI11~^wV RECEIVED NATION AI POLLUTANT aSCNAAOE ELIMINATION 5VSTEM /INPDESI <br />DISCHARGE MONITORING REPORT /DMR) <br />NAME <br />ADDRESS JAN 0 2 200 <br />PERMIT NUMBER dscNAAOE NUMnEII <br />_ plWg;ran ot_ Reclamation, MONITORING PERIOD <br />fAClLrnr Mining and Safety YEAR MO DAY YEAR MO DAY <br />LOCATION : { 5~ i ... FROM TO <br />Form Approved. <br />OMB No 204Q0004 <br /> <br />~ - ~ 1 IV~+L <br />~ixivr =r~l-lifV?ib~ 'Ii:: i'J PI•~ i= <br />NOTE: R~~d If»trucdorn b~1w~ eompl~tlny this form. <br /> <br /> <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION NO. FREOVENCr <br />of SAMPLE <br />PARAMETER EX r <br />LVg,g TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ,Ur, <br />, <br /> SAMPLE <br />MEASUREMENT <br /> <br /> PERMIT <br />E <br />T #x.k:.._ I <br /> REQUIREM <br />N <br /> SAMPLE <br /> MEASUREMENT <br /> ':~~ <br /> PERMIT ~ifa> - ",-~•#ir ~ ._~ <br /> REQUIREMENT <br /> <br /> SAMPLE <br />i ~" <br />~~ <br /> MEASUREMENT ' <br /> - Un li <br /> PERMIT ~ # ~ . <br />,:Jf) <br /> REQUIREMENT ' <br /> SAMPLE <br /> MEASUREMENT <br /> " ;;~ <br /> PERMIT ~ - ~ ~ # I . <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br />"' " <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT ~- ~ ~ <br /> - <br /> PERMIT . r;: T <br />;. ^:~':~ <br /> REQUIREMENT _ i=> <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br />PERMIT <br />REQUIREMENT <br />NAME/'fITLE PRINCIPAL EXECUTIVE OFFICER ' n^'Ir u r pen• ry o I^+ th^t mle document •nd dl •uKhmenu were TELEPHONE <br />Prep^red under m~ dl retllon or fuper+ilon In KCOrd ^n('e .Ith ^ rrsltnl dal~n[d DATE <br />la awre Ih^1 qu .Hoed perwnnel Properlf t•Iher •nd er^lu^te Iht Infornulbn <br />h <br />th <br />l <br />0 m^nge <br />e 7Jf <br />rm, <br />wlbmllled. tt^rrd on m] Inqulr) or nl^ yenon er Per^oro v <br />or Ikon ptrwln dlrectl~ respo~dbk far E.Uer1n~ the Inform^tla0. IM Infonrrllon <br />wbmillad br, to th^ best of m7 know4d~e ^nd benef, true, tlccvnle. •nd romyklt. <br /> hbe Infenrotbn <br />dnc,nt <br />endtln far rub~tnn <br />tl <br />l <br />h tIONATL/RE OF PRINCI-Al EXECUTIVE A A <br /> , <br />P <br />~ <br />1 ^m ^w^r~ t <br />+ere ^re f <br />E <br />^t <br />k <br />td^tlo <br />d <br />t r <br />.l OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />TYPEp OR PRINTED ns r <br />Irny11^ont>ten <br />or <br />no <br />ns <br />IMud1nE the po.dbiny al one •n <br />COMMENTS AND ExrL~n~ 1 lvn .,. ,,... .,.,..-...,,..,. ~.....,.....+ ~. _..__.....-•--- •~-~ -. <br />RAGE I~~ HIGHEST MJNTHi_.Y AVERAGE DURING PERIOD REPORTED. <br />This is a 4-part form. PAGE of <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used. <br />