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PERMITTEE NAME/ADDRESSp~.r~~rirwryN../LocrfawVD(Qi.w1
<br />NAME ,
<br />ADDRESS c:.i-i ~ ..
<br />$OX 187
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<br />FAaLITY 'pER MINE
<br />Loc.ATtoN i G C O 81625
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<br />NATIONAL POLLUTANT gSCHAROE ELIMINATION SYSTEM /INPDES!
<br />DISCHARGE MONITORING REPORT (DMR!
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<br />PERMIT NUMBER psCHMOE Nt1MSEtl
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM _- TO
<br />Form Approved.
<br />OMB No. 2040-0004
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<br />L3I~CHaRGE TO H©R5E Gt1LCH
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<br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NQ,
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<br />NAMElTITLE PRINCIPAL EXECUTNE OfFlCER 1 °` ' ~ ° ` v'"e tr 0 .. Ihel thN mrnl end etl .le.chment..en
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<br />TYPED OR PRWTED L-, InefedlM the poeelAlMlr or Ilne."d Imprlso""wnt br k"o»I"E HdeUoro. OFFICEII OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY vIVLA iIpNS /R~hr~nc• M •rr~cnmenr~ n~r~l
<br />., .- ;~* :;$L->= SOLIDS LIMIT APPLIED FOR '=1DYR, 24HR PRECIP EVEt`JT-
<br />EPA Form 3320-7 (Rev. 3199) previous edfions may be used. `G 4 1 i ;' ~ J~•1'e'P~~/8i4'P~"~4~ • PAfiE AF
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