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PERMtTTEt; NA1,lE/ADDRESS (7.dr~. fr+iy xwdLo~~uar dp~,~ <br />NAME ~ , - . f~Sl_ <br />I NE's <br />ADDRESS <br />t=~ILISF~DE CU Ei1S~ <br />FACILtrY hl7ADS i i)E NORTH & 517UTH MINES <br />LocAT1oNI~EAR PALISADE CO 81~] <br />- IVcL.SUN L. V.IDD>`~' V. F'. <br />Form Approved. <br />NATIONAL POILVTANT dSCHAROf fLIMINATON SY9TQA /INPDESJ ~,! _ NO~ OMB NO 2040-0004 <br />DISCHARGE MONITORINQ REPORT (OMRJ <br />- t ,UI3R , . <br />PERMIT NUMBER DtstHAROE Nt1M0EN } t, <br />FtOAD~ i:__~ ~. ~.:~ TCi COi_C; Diu ~tI' <br />MONITORING PERIOD <br />YEAR MO QAY Y R MQ' D Y r.l,-~ - ~~~ . <br />FROM TO <br />NOTE: Read ht•ttvctlor+t before completMy this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CGNCENTRATION <br />NO. <br /> <br />EX FgEOUENCY <br /> <br />OF <br />SAMPLE <br /> <br />TYPE <br /> ANA~rsls <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT _ <br />' ~ <br />' <br />~` <br />~ PERMIT <br />~ <br />f•I I i <br />- ;1 <br />'I <br />:~;r ~ "~~. r: - <br />_,, <br />. -.~ .. <br />r ~ , _~, ~i•d ? ~ r <br />. L <br />~ REQUIREMENT , . <br />. ~ <br />' " ` SAMPLE <br /> MEASUREMENT _ _ <br /> <br /> <br />_ <br />~ ,-~'_ 'J~•~l <br />i-: <br />`_t=i4: PERMIT <br />?C~)J~i !'1nX <br />'".'•~; <br />._ . <br />.. <br />• __ <br />. REQUIREMENT <br /> SAMPLE <br />HRU ~! RE'AT hltN ( . ~;_ AN I MEASUREMENT <br />` <br />' <br />~a <br />1 <br />.•i <br />lO <br />O <br />~Fl <br />E- <br />k1F <br />`; ` •~ <br />~ PERMIT , ~~ <br />_ <br />. <br />. <br />- <br />_ REQUIREMENT r <br /> <br />'[ _ <br />~ <br />_ _ <br /> SAMPLE <br />'! I SUAL MEASUREMENT <br /> <br /> <br />UENT ..G~ ~ - ~ ~ F <br />"-l PERMIT , <br />~: =. <br />~;,' r~ <br />_ REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PJ^RMIT <br />REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER ' °"""' " Pe"' ~r ° 1i'n"'nM °°"""`"""° ~' "i"n"""s ""` TELEPHONE DATE <br />prepared °ndet ,wr dlreellon a fuyer•'Ifrow In .ccvrdnur r11n . fr.~em darned <br />~ • ~ :.~ le anurt IA.1 qu.nned pere°nnel ifOVe~1 i.teee .nd e•.h1.le IM Inforen.lbn <br />, <br />~. r• <br />G <br />~ <br />~ <br />-. <br />fnemilled. bred on m• Inquiry d the tenon er yen°ru .n° rern.Re lee s)slem. ~- ~ <br />. <br />~~ a leant penees directly repon/ek ra pterArn Un Inronrutlow. the Inl°rnrtlon - <br />~', ~ ~ -~~'" eyerrdlled la. to lee ear or m~ Yno.ted~e end Detlef. Irre. nccvnle..nd comylete. <br />ew. <br />1f~.1 In <br />f1 <br />Nfkawl <br />litln <br />f10NATURE Of /AINC!-AL EXECUTfVE <br />1 <br />e <br />neln <br />e <br />hM I <br />r <br />rrr <br />b <br />lb <br /> ~ <br />.~ <br />re <br />tre <br />n <br />oe <br />a <br />r su <br />m <br />~ <br />o <br />u <br />n, <br />n <br />TYPED OR PRINTED Inrfiedlrq,ee p°edemry ornne.nd Imprte°nmrnt ra kno.1"~ .id.uwn OFFICER OR AIJTHORIZEC AGENT CODE NUMBER YEAR MO DAY <br />it <br />COMMENTS AND EXPLANATION OF ANr vIVLA I Ions Ilre>'arence M err~,cnmants Harp ~~TAL SUSPENDED <br />I - <br />EpA For" 3320-1 (Rev. 3/99) Previous editions may be used <br />I <br />~>, ~arAL_ IRON <br />is a d-part form. PnaE of <br />