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f'ERMITTEE NAME/ADDRESS pweYJrFaWryNrw/Leenrowl/DIQGr~r)
<br />NAME q}~SQI,,1 C1IN ~1~fQ, L_LG
<br />ADDRESS 5A;'JL ~~R~i ~P~Z, gt 1"LK %,#~)^, X17. ~1~
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<br />FACILITY SANB>~3Rf~i f~Ri~ 4t ~~_~. QI;K MINES
<br />LocATioNcgi"IFRSF'F f't=t S' A•3~b
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<br />NATIONAL POLLUTANT aSCHAROE ELIMINATION SYSTEM NPDES/
<br />DISCHARGE MONITORING REPORT /D R)
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<br />PERMIT NUMBER ascNAROE NuMeEa
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM ~J5 :~};~ i.?2 TO ;~8 {:j~~ ,;ii
<br />M7 NqF~
<br />Form Approved.
<br />OMB No. 2040-0004
<br />5!~1`?IC~llrl`~_; i~i7P~~Ls T q ELK {::I:Z1rEl/4
<br />NOTE: Read imttucdom b~fw~ compl~tinp thb ftxm.
<br />PARAMETER 4UANTITY OR LOADING QUALITY OR CONCENTRATION NO,
<br />
<br />EX FREOUENCV
<br />OF SAMPLE
<br /> ANALYSIS TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
<br />p)..( SAMPLE •#••k: #•fc## •~##-k•~ti•# •1?••K ~: #••k•#• { 1 c }
<br /> MEASUREMENT
<br />UQ4C1~r I
<br />D O PERMIT •u•~-~ ##.a ~--~#->t-t~af •~••It••kL 6. 5 #####•#- yam. O NSF/ I NS I T
<br />.
<br />1=Fi=Li..)ENT (aRC755 VALU ftEClUIREMENT
<br />;.:.;
<br />#~•-Y~#
<br />1'~ "
<br />MAX I IWSJM
<br />511
<br />Mf~hd7
<br />SgLIDS: Tu`f`AL SAMPLE •tE•if•###•>, •#•##•~## •tr#•~•r••tt-•~ ( ~,`,~}
<br />5t}5PE3~1171fD MEASUREMENT
<br />Q4~aO{7 1 ~` {7 ;PERMIT' at•tt-#•~~# •tt-###it•# #•tF•••tr ##•1~### 35 70 3~iCF/ RAD
<br />EF'FL.U53`~T QRgsa {rAL.~J FiEQl11REMENT .~..~.## 3~DA A~.'U I?AiLY M7{ MQ/L. M~3NT!
<br />SCiL ~ T7ta, r...l-'~! TL1~ATILE SAMPLE -!~•##~•#•#• •i~ #•!t•#3L•fi• #i'c••It•##i~• { G?5 }
<br /> MEASUREMENT
<br />t7~}5~1•S 1 C~ {? i'ERMIT' #~-#### ####~•# #•tt•~;r ###~## R>"PQR7 REPORT NCE/ RAB
<br />1=FFLUEIVT Qi~g55 VALE EtEIlUIREMENT.; •~#•~# 30DA AVG AILY MX ML~'L MDNT
<br />IRgN, TOTAL SAMPLE ~#-#if-### •#•##•>'E•#•# ##•it•#•>t•!~• { ~~}
<br />{ ~~ FE } MEASUREMENT
<br />~}iQ~•5 x U ?;,? PERMIT #3l-it-•tt•+PdI- ##~E##•#• . #r#•#• St•!1•iFjF#iF- 3(}{ 6~}~Q I~E~ Ia~AB
<br />5F'FL~.1E1~tT raFtD55 i~ALU :REQUIREMENT
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<br />... ~ .~•~••~•~. ~~] A Auk- D~,I~..Y C'~X #.1ClL
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<br />DID. AND GR1=A.~E SAMPLE .~..}{..~.•~.~..ti. #•~••>, •1F•## •~•###•!<# ##•k'••if•#dE { x 9}
<br /> MEASUREMENT
<br />C~~58c~. 1 G {~ PERMIT ' ~; ### ,. 1~ ~ :~. ~~ "`:
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<br />EFFLd..IE#Vi' GRgSS VALD
<br />~iEf1UIREM(=N7
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<br />f 1- T ~. ~ Ih15T MAX MQ/L ''fi'r`
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<br />FLOW, It~J GRNDUIT C}R SAMPLE { {7O) +-##~~r: #-~-~;~~ts ~t-~-t~,:=•tf
<br />THRU TREATI'1ENT PLAN MEASUREMENT
<br />5Q45{7 f. 0 q f ERMIT ` R1~PDRT R~P~R7 ,: {t•ic•tt•~t•~t•# +c-~ita~#-~ ~~#~#~ -#•tt-•~• NCE/ INSTA
<br />EFFLUENT S3l2D55 VALU ~~auIREM~N'C
<br />.. g0I}A AVG DAILY `~7X MOD r ~#•f ~ MC1NT
<br />,C.~GL1' I75, TD~'AL SAMPLE # ~ # fi ~ ~ •3i # 3i # ## t is ;; ii v ?r { ~,.~ }
<br />l7I SSCtLi~Ela MEASUREMENT
<br />:7{?~ 95 1 0 t} PERMIT ###~#~ ###### ##•rt• #tt,#### REPORT RI~PORT RLY ~C~R ~
<br />EFFLLIEN7' '^R~ar' ~ VALLI REQUIREMENT •!i•#•!I-•it• QR T R Ati'{~` DA I ~...'~ I'~ }; elf=.` i`!_
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<br />PRINCIPAL EXECUTIVE OFFICER
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<br />TELEPHONE
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<br />I'`'~~ to aaure that quaMOM personnel P~H7 bather and erduNe the information
<br />aabmltted. Saud on mr Inquiry of the person or penom who manage the system
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<br />wbmltted h, to the bell of m~ knowkdEe and beMef, true, aecuratq and rompkte.
<br />I am lwaR Ihal IAlR aR sl(IdflpM penaltttl fOr aabmlltln
<br />tabs Informatlon
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<br />b10NAToRE OF PRINCIPAL EXECUTIVE g 1
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<br />TYPED OR PRINTED Ineludlnt the podbluty of tine and ImpAaonment for knowing vldaUo~ OFFICER OR AUTHORIZED AOENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION vF AnY v1oLA r wNS /Rdamce sii ~tncnm~nta has)
<br />T55 QF TL"7T,~L I RC)T~ L I M I T5 W I L.L IiE WAIVED, At~iD SETTLFAI3L1 SOLIDS LMT APPL 1517 FqR t; = I QYR, ~?4NFt PR1=Q I?~ 1=V1~NTs
<br />SETTLEABL.S 5DLID5 LIMIT MA'>` D1± WAIVI^17 FqR =~ 1{:)YR, ~•4HR EVENT--SEE I. A. 1, R'P 4--5, ANU I. A. ~, ~'. 5 F47t? R#7MitdTS.
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<br />EPA Form 3320-1 (Rev. 3/99) Previous editions maybe used. ~~~~y ~ ~ ~ yt~~$r~ ~i~h~€j~,rtt7 , PAGE OF
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