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PERMITTEE NAME/ADDRESS rlnrludr FacJiry:vamrllixanon rJAiJJrrrnf) <br />NAME _.!~ '; I;I~, i_L-:. <br />' ADDRESS - _ .. ~' ~ 1 .`d tt <br />IJ. BQX X28 <br />JCS. r1 CU 81424 <br />FACILITY _~,~ ty<aR T, ZON MTh~>; <br />LOCATION ~ ALA (;p 8142 4 <br />n r.tr^~ ,.,nriC ICI ~ h.!x: MAI•.IGa2FR <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 />Ry~MINE T~RNG TRIB TO rt <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NQ, FREQUENCY <br />OF SAMPLE <br /> EX LYSIS TYPE <br /> ANA <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENTI <br /> PERMIT .. R8f UFi~~ ~ ;i:•~ <br />' =;~' <br /> REQUIREMENT !3A I Llr' h! k :, I''!t.~i'4 <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT -. ;:v~-:-:: - i<~i='Qft-f t'.:a:L,R•~ <br /> 'REQUIREMENT ' :: ,^~ A'Y C; ~r H 1 I Y i`. Y . <br /> SAMPLE _ <br />i) MEASUREMENT <br /> PERMIT •,. ~; it s: - +::• k i5 - : Y -r T - . . <br /> REQUIREMENT - - ~~` - ' <br /> <br /> SAMPLE <br />,,: <br />~y; MEASUREMENT <br />- PERMIT ,, .; .. - ., 4. _ <br />• REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I crrlir. under prnall) of law that this document and all mtachmrnt+werr TELEPHONE DATE <br /> prepared under nn' dirn~tinn ur +uperv ision in oecarrlanre with a system drsiyltrd <br />~__ kr a„urr tlmt yuablkd prrsonm•I pnyn•rly Rather and esuluatr for infnrmalinn ,. _ <br />~ <br />- wbmitlyd. fta+ed un mr inyulry nr the person ur prrvrm who manage the +y stem, <br />nr thw prrum.dirt-ctl~ responsible fur kathrring tha• information, the information .• <br />*- - <br />-, ~' / _ <br />- <br />~ <br />_ ,~ <br /> <br />~ `~ <br />~ d b <br />true <br />uratr <br />and rnm <br />drtr <br />itt <br />t <br />s knowled <br />e <br />li <br />f <br />aa <br />b <br />d i <br />th <br />h <br />t <br />f _ <br />, <br />~ ~ /~ J <br />- <br />•1 <br />) ~ <br />L L?~ <br />I L <br />' • . <br />, <br />F <br />. <br />s, <br />o <br />m <br />g <br />an <br />e <br />e <br />. <br />r <br />w <br />m <br />r <br />o <br />e <br />es <br />' SIGNATURE OF PRINCIPAL EXECUTIVE ~ <br />- <br />' <br />- ry;nific:uu prnaltio fur+ubmiuinR fal.r information. <br />1 am •rwarr that tltcrr arc. <br />i <br />ti <br />k <br />i <br />l OFFICER OR AUTHORIZED AGENT AREA <br />NUMBER <br />YEAR <br />MO <br />DAY <br />TYPED OR PRINTED / now <br />am+. <br />including, the p.r:6billq of tine and impri+rmment (ur <br />ng . <br />u <br />a D <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br /><<;. - ~ '3r0-I IHev 3+44; Pro-a;~~.,; ~~. ~~s ~ _, - <br />Tlii3 i~ a •~-G1:iit aornt. PAGE Of <br />