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I PERMITTEE NAME/ADDRESS ilrtrlxde Fnrilin .Yumr/lt~rafmrt ifUiffinrtp <br />NAME <br />ADDRESS NEC:A MINE GOhIPL.EX <br />~, Gi7:C E,7C;' <br />vr~FN (;t~ 5163 <br />FACILITY "'FM M~P~JE COP"F'~E:{ <br />LOCATION -, `N ' r) i:I 1 b 3 <br />r h.AR(7, FtFC'! ~,'~,~.` rflnt NiAI~lei!_T-'R <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM ((NPDES) <br />DISCHARGE MONITORING REPORT (OMR) r <br />PERMIT NUMBER DISCHARGE NUMBER ~' <br />MONITORING PERIOD L <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />AIATC. ~......1 I....a.....~:.. ~.. 1. _. <br />Form Approved. <br />OMB No. 2~iD•0004 ~ <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NQ, FREQUENCY SAMPLE <br /> OF <br /> <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS EX ANALYSIS TYPE <br /> SAMPLE <br /> <br />MEASUREMENT _ <br />~ r <br />= <br />~ <br />.' I ; <br /> <br />1 <br /> <br />, <br /> I , <br />~ <br /> PERMIT ' <br /> REQUIREMENT . <br /> SAMPLE <br /> MEASUREMENT <br />-_.~ ' <br /> <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT i ~~. ~ ~ <br /> <br /> PERMIT ._ <br /> REQUIREMENT , <br /> SAMPLE <br /> MEASUREMENT i - ~;~ <br />_. <br /> _ <br /> PERMIT <br /> REQUIREMENT , <br /> SAMPLE <br /> <br />MEASUREMENT ~ <br />(r ~ <br />' <br /> _, <br />C <br /> PERMIT ~. T .:. ""t_r' i . <br /> REQUIREMENT ;_ <br /> SAMPLE <br />:y ~ _ . _ MEASUREMENT ~ '~ ( ~ J - 1 I f 4 ~~ <br />' 'J <br /> <br /> PERMIT ~ .~ - <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT ~ I f_~ - ~ •"~ '~~., <br /> <br /> PERMIT <br /> REQUIREMENT , <br />NAMEffITLE PRINCIPAL EXECUTIVE OFFICER { certifi and. r lamnth of law that thk d~aunlrnt and all anarhmem.+.ere <br /> <br />prepunrl under nn directiim or .uper+ision in accordance with a yriem dr+igtlyd TELEPHONE DATE <br /> to awwre Ih:u ylwlifird prrumnrl pmperi~ );athrr and rvulurte the Informati,al <br /> suhmiu+d. Bard nn m+ inyuin~ of Ihr prvsnn or per.nn. +rho manaRr IM +y~aem. <br /> nr Ihrne prrw,n• dirrcll} reytumible far K:athvrin>; the ;nformalinn. the information <br /> cubmiual is, w the Ile+t of m+ knnwled~e and helkf, true, ucrurnte. and complete. <br />1 am aware that there <br />i <br />nifi <br />i <br />l <br />G <br />h SIGNATURE OF PRINCIPAL EXEC <br />TIV I <br /> <br />TYPED OR PRINTED are . <br />{C <br />cant pena <br />t <br />e+ <br />+r +u <br />miltin>; lal+e information. <br />indudink the Iw.+.ibilit~ of fine and impri onmem for knowin>; +i.datNm.. U <br />E <br />OFFICER.OR AUTHORIZED AGENT <br />AREE NUMBER <br />YEAR <br />MO <br />DAY <br />rnMMFNTC ANfI FYDI AAIATIfl1U /lC AIJV \/IAI ATllIAIC /Onto......... ..I! ..w....c......~•.. t. _.._+ <br />~>`T~f7 r,:.I~l_>=t;,'jI171`: OF' =', r::;AMPLES, - '1F'?~ <br />,...,, T, <br />V ~ IM ~ k liv, ~ i G 1 Vl '~ 1 ~., ~ . i A . r_ I1 !'~ {__. ~ t~ ~ F <br />I• A jR~AS~NACiLE P F <br />-... ~,~ <br />EPA Form 3320•t (Rev. 3/991 Previous editions may be used <br />