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PERMTTTEE NAME/ApDRESS (In=eM/r FweihryN~/Lerrlen I/DlQwrv) NATIONAL POLLUTANT dSCMMOE ELIMINATION SY9TEM (NPDESI <br />NAME DISCHARGE MONITORING REPORT /O RI <br />ADDRESS ~_ _:< <': ~ ~•,.. <br />~. BOX 18? PERMIT NUMBER dscHMOENLIMDER <br />- I G MONITORING PERIOD <br />fAaLITY =PPER MINE YEAR MO DAY Y AR MO DAY <br />LOCATION ~~. I (`„ C ~ B 1 L- ;-: ~ . FROM TO - _ <br />•"-.YMTitVn (~ T)tl RfIIS. PREP/GM <br />Form Approved. <br />OMB No 2040-0004 <br />MINOR <br />(SUBR JC> <br />t= - F I NFaL P'IO i= AT <br />WET TESTING Fi'7R 024A <br />fi:... •fC h. - . <br />NOTE: R~~d k»trucdorw D~io~• compbtllly this tam. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION Np, FnEOVENCY <br />OF SAMPLE <br /> EX TYPE <br /> ANAtYSps <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />. .. ~ • ..cL -: -. ~ SAMPLE - ~,.. <br />. / ! ' ; <br />i_:'.'r,. rfhJ I ~~ MEASUREMENT ~~ -' /~ % <br />~ ~ <br />.~ '_ PERMIT ##•;Fs-~~--~ ;~-sr~-•xn~ - - 1U _. G? a#stai-~:;, --s =~t## ~_` ~~'A.~ <br />_ UENT 1 REQUIREMENT t'IN VALUE: - <br />S tt . r SAMPLE -. _ <br />~ ... ~ <br />' <br />"`F_F'NALE MEASUREMENT ~% ~ - <br />~ PERMIT ~-',:~ - r~;t:~r.>,.u-;: 1~~1 _ ;i ~~~•##=. #~;t~-#i: •. +~~ ! =i .: <br /> REQUIREMENT _'~ :, = MN VALU>=- • • <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 /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/'TITLE PRINCIPAL EXECUTIVE OFFlCER ' `~^"' " " pt""' o L. tna th <br />nr <br />.raA under m <br />dlrectlon er fu y e«,~ment .ne .u .necnm <br />errMow In sxewdance wllh enb were <br />. s)sletll desdjned TELEPHONE DATE <br />- ~ <br />/,.-..I . ~ ~ ~' ~ L .,'-' / ~- <br />• p <br />p <br />l <br />p <br />le.pre tAN qu.Mfled perfonnN properly ~Nher end erNuNe Iht In/er+nallon <br />fubmltttd. 6sued on .nt I.uautry of tix person a persdr whe imneee IM systtm, <br />or Ihoet prnoro dlnrttiT rnpewsfblt for plherln= the InlormNbn, IM In/otrrrllon ;'• <br />,. ~ ~ f / % y <br />/ ~-_- • L'V~ -'"C, ",• `L-~=-~ <br />•~ <br /> <br />. <br />r <br />~ `•. ~ <br />~- <br /> <br />~ <br />~ <br />. ~ <br />~ <br />~ <br />^ to the heft of m7 kwewied~e .nA EeYef <br />Iroe <br />sncunte <br />ead rompkle <br />fuprritted h / <br />• • <br />' ' <br />~ ~/~ <br />' /~ <br />• ~ , <br />, <br />, <br />. <br />. s10NATURE OF -RINCMAI EXECUTIVE ~ <br />' I em ^.ere UN them ere fl(rllfltlN penNtle lot wprdltln~ fNfe Inlorrmdon, <br />TYPED ~ pR~J•Ep ` InckdlM the possfelul~ of nne.nd Irrtprlsonrnenl /w kno»InE rlol.uetat OFFICER OR AUTHORIZED AoENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Rtr/~r~nc• wNN ~tt~chm~nt~ hlrr~l <br />' RF'°QP.T. l_rSfJ - STATISTICAL POINT ESTIMATE WHICH IS <br />. ~~:- -- - __ . REPORT FORM i ~ ~.~ ...: - ;:- i .- ` ~:._ N07 <br />EPA Form 3320-1 (Rev 399) Previous ed~bons may be used : ~ r ~ C `This.i~,a,~-Q~rL.;fOrtT1. PAGE OF I <br />