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PERMITTEE NAME/AODRESSQweYr i~rWryNa./L«rra~l/D~Qi.wv) <br />NAME <br />ADDRESS <br />Isux ~~y <br />--RSt=7' CCJ E <br />FACILITY ~:'17RN CFiK ~r 1_L,K CRK MINE; <br />LocATaN ~_i-?StvT CU ! <br />:1~5 T. CDUC'>=R, EXEC V. P. <br />NATIONAL pOILUTANT OISCMAROE ELIMINATION SYSTEM NPDESI <br />DISCHARGE MONITORING REPORT /D RI <br />PERMIT NUMBER ascHAroE NuMeE>t <br />MONITORING PERIOD <br />Y AR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMB No. 2040-0004 <br />iiN~ t'ONE? `~ C~ HIJF3i3R <br />G~ ~ _. <br />~~ <br />NOTE: Raad InatrveMona batwa tomplatlny thla lam. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NQ, FREOOFNCY SAMPLE <br /> <br /> <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS EX ,wr~r~s TYPE <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT - .. : _,. ~ U <br /> .REQUIREMENT M I N i (Kt t."? ~ ~ ~ , ~' :'~ <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT _ ... <br /> REQUIREMENT ;~; i;,}::; +y'.,i.... <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT ~ .. ~ ,- r ~~ . , ..1.•. <br /> REQUIREMENT ~!.,, i ( ~, ` <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT .. - --~: ~ 1; . <br /> REQUIREMENT _ <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT it ,,_ ., ;= x - ~ . <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> <br />O ~ PERMIT _ . .. <br /> REQUIREMENTC <br /> SAMPLE <br /> MEASUREMENT <br /> - <br />, , , <br />PERMIT _ <br />REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER ' Ce""~ " ` a"''r ° I•w th.l thlf eaevnrnt .ne .tl .tlrcnlnrntf were <br />TELEPHONE <br />DATE <br />prsprred under mr dirsclton or aper+l~on In Kcord•nce wllh ^ f)flefn defl~nrd <br /> to afwre MN ~u•Hfled personnel propeAr i.tMr •nd eeNu.le IM Inferelrllon <br /> fabntltled. 6~ed on ,nr I,pulry o! the prron a perforo who mrelr~e the frftrm. <br /> or thole prefers dlrectlf refponflbk tar trlherln~ the Informrtlon. the Inlorenrllon <br />. - , fubndlled h. b the bell or my 4rwwkd~e end beMrf, IrVe, wevr.te, end tompkte. <br /> i .m r..rs thrt there .rs flprnnm pen.ltfrs for penrtnn~ nbr Inrorfnrtbn, tiiONATUi1E Of -RINCt-AL EXECtIT1VE <br />TYPED ~ pR~~p Including the pe.lelaq or nne.rtd Iwtprlfonmrm roe Ilna.lni .Id.tlorts, OFFICER OR AUTHORIZED AOfNT CODE NUMBER YEAR MO OAY <br />COMMENTS AND EXPLANATION yr Anr vIVLA I IVNS /R~lar~nca s/r' artacnmant~ hartr/ <br />r - .' T)=' !...I'^1 -_ - -raj iF= <br />PAGE OF <br />FPA form 3320-7 (Rev 399) Previous editions maybe used. TIIiS ~5 8 4-part fOrnl. <br />