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PERMITTEE NAME/ADDRESS r/nrlude Forilit) .4'mne/lnrauon ijUiJJennt <br />NAME _ . <br />r .~c:_ <br />ADDRESS zON 1"IINI: <br />iJcl7 <br />FACILITY -` a ZC3N MiNf <br />LOCATION _A <br />GO 8142 <br />Mlai'dA[~~I~? <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM ((NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />oMa No zoaaoooa <br />5l~~<I"fItVF TfiIV~~ Tf?Ia TO T;_1TTLE r <br />_/% <br />l! <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY <br />OF SAMPLE <br /> <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS EX ANALYSIS TYPE <br /> SAMPLE <br />MEASUREMENTi <br /> PERMIT -t -:. <br />REOUlREMENT - ~ rtl.i-1~-, <br />;y,,',; <br />f'; hiX <br />'_ , <br /> SAMPLE <br />MEASUREMENT <br /> <br /> PERMIT <br />REQUIREMENT ~ <br />q\'~. ~ <br />%'r- ~ <br />i~iCl-vT"r , <br /> SAMPLE <br />MEASUREMENT , <br /> x, <br /> PERMR <br />REQUIREMENT ~# ,~.~.~.T <br />. ~ = u <br />DA T LY ~'~: ~C <br />'. _ _ <br />- <br /> SAMPLE <br />MEASUREMENT <br />' <br /> ~"~ - <br />t=i <br />#= <br />1 <br />- <br /> <br />. PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT . <br />:, <br />, <br />. ... ~r .:, t <br />lira AVI> <br />~AiLY P '~ <br />_ . _ . <br />'~?' :" . _+ ; <br /> - <br />, <br /> PERMIT <br />REQUIREMENT .~ ...~ .. <br />~'sOC}A AV(~ _ I <br />~ - ; i _Y +."~I'' ,~ <br />t t <br />!'"i (71~ ~-rn <br /> <br />-f'a i il~t_._ ~ i ~`_~ SAMPLE ~ <br />MEASUREMENT ' <br />• ~ r~, ~ - -, <br />- <br /> <br /> <br />~ PERMIT <br /> <br />REOUIREMENT , <br />. <br />, ,. <br /> <br />; _)DF- r' - <br />_ <br /><%r`,;i'. l '., c - <br />.. . <br />t:v ~: ; <br /> <br />: SAMPLE ~ <br />MEASUREMENT • <br /> ~ <br />sr ~ <br /> PERMIT <br />REQUIREMENT' .. ~. r t_' <br />-.. ";.~ r','. is ., <br />.i, r,_ ~ <br />~:,; <br />NAMElTITLE PRINCIPAL EXECUTIVE OFFICER I cenirs under penalty of lux that this ducutnrnt and rll atWChmenl+ xere <br />prrparrd under ms Airnlion or supervision in ucn,nlance xith a system drslgned <br />- <br />-_ <br />~ -_ .._ <br />- <br />TELEPHONE <br />DATE <br />_ _ - <br /> <br />' ~ to assure that qualified personnel properly kathrr and rcaluutc the informadun <br />sUhmitled. RLLSiYI .m my ioyuin of ttte perFM or ptrv,ns x ho manoRe the system. <br />or thux persons dircetly respnnsihtr fur yatbrrinA the infurntntion. the information .; <br />- <br />~y~ ~ <br />~ -- ~- i <br /> <br />' <br /> <br />- <br />~ <br />` suhmin rl Es. In the brst .,f my knnxledge and Irclkf. True, wruntr. and campkta <br />I <br />x <br />th <br />t <br />h SIGNATURE O - _ <br />,.~~_ / <br />` ' r ~~ Ll <br />~ ? -' ' - - ' -- <br /> um a <br />are <br />a <br />t <br />rre are significnm penalgn fur whmiuing false infnrmutlon, F PRINCIPAL EXECUTIVE ` <br />TYPED OR PRINTED <br />COMMENTS AND EXPLANATION OF nNV vlnl hxiudinp the possibility of fine atui imprisonmem ror AnuxinK ridatwtn. <br />OT1nNR iar,rprA.,~e sll ~Hnnhenunen ti...,.t OFFICER OR AUTHORIZED AGENT AREA NUMBER <br />OD YEAR MO DAY <br />±; P-..: _.:, .-.. r1~i, 1, a -~-i)ati tc~fni PAGE OF <br />