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NATIONAL POLLUl'AN7 ARGE ELIMINATION SYSTEM <br /> DISCHARGF 1WiCRING REPORT <br /> ..O0.pproved <br /> J58-f20073 I <br /> i <br /> ' '''ai-CT CnA;_ (PREP PL!NT <br /> E. <br /> PO PDX 158 <br /> I i <br /> 1 c Ai"��'1v�1ALE INSTRUCTIONS <br /> f: <br /> 81623 1 I. Provide dates for period covered by Ulis report in spaces marked"REPORTING PERIOD". <br /> L J 2. Enter reported minimum, avenge and maxiumul values under"QUANTITY"and"CONCENTRATION" <br /> j Iz v 14 let m 1st In the units specified for each parameter as appropriate. Do not enter values in ba Aes eortaJning i <br /> -) asterisks. "AVERAG " is ava>:age ccwputed,iver actual time discharge is operating. "MAXIMUM" <br /> I �—n n � � and"MINIMUM"are eztrcme values ahtcrved during the reporting period. + <br /> •M n 0 396 )j 1111 3. Sp c.:ify the number of analyzed samples that exceed the maximum(and/or minimum as appropriate) t^ <br /> 8T PERMIT NUMBER DIS SIC LATII'U UE LONGITUDE permit conditions In the columns labeled"No. Ex." If none,enter"O". k <br /> —j 4. Spacify frequency of analysis for each parameter as No. analyses/No. days. (e.g., "3/7"is equiva- F <br /> 120-21) I22-2a1 tzazm Iz6•271 I2e•291 (so•au /ant to 3 analyses performed ovary 7 days.) If continuous enter"CONT." <br /> I-- S. Specify sample type("grab"or"—hr. composito")us applicable. If frequency was continuous, L <br /> enter NA". .. <br /> 'F ! REPORTING PERIOD: FROM YEAR <br /> i't+ 1 TO 9 t,7 1 6. Appropriate signaicre is required on bottom of this(ono. <br /> ,F YEAR MOL�j, <br /> AY YEAR MO DAY 7. Remove carbon and retain copy for your rccords. . <br /> a 8. Fold along dotted lines, stupfe and mail Original to office specified in permit. 1� <br /> �_ 16.r-ael lao-roa <br /> (3...d only) OIJANTITY (4 card only) CONCENTRATION FREQUENCY <br /> 136•461 1jl6_63) Itl.•611 462.63113 -.a) 1.6•tl31 ttl.-611 !C2-631 SAMPLE <br /> { PARAMETER - -- --- NO. NO. OF <br /> i MINIMUM AVERAGE MAXIMUM UNITS EX MINIMUM AVERAGE MAXIMUM UNITS EX ANALYSIS TYPE }{ <br /> 2 <br /> f UIT REPORTED U, jr # # G # # A it # # # O (r7 !� <br /> FLOy'i IN rOn.: It D i <br /> M — _. — ----- <br /> MGD - <br /> � f•GD <br /> ' tit,. PCRMIT G ;i # k l IN 'r <br /> ) _, ..SJ CONOt TION 1/ t <br /> -OLIOSr TnTAL DISS REPORTED III ItIt # # # # # tt .# # it it # tt # 1803 # # # # O tlgp <br /> (11)l;Si Lv I�) —_ KG/00 MG/L <br /> PERMIT <br /> 7•-i3 v CONDITION p # # # q it It It # It R # k # It It # # u U # G 1/90 GR r <br /> --- -- - - --- <br /> ``l•LTf)S, TOTI•L SUSS REPORTED # tit # /F G ti it # # # # tt tt # X # It # o # f (!qa C� <br /> (SUSu tIrE�) KG/DAY NG/L <br /> PERMIT <br /> CONDITION 30 1/90 CO <br /> _n0'1tTOTA!_(4S FE) REPORTED Gp.c1 0.01 Il�v Cry <br /> PERM, - — KG/DAY - -- tor,/L <br /> 1/90 CO <br /> +< # # # p # tt # # # u # # tf <br /> 1•.)45 CONDITION 3s5 7.'_r <br /> FN>r'IELO REPORT 8.3 d f/CIo G>z <br /> :I 1 PERMIT SU - _. __-_.___ C JU _. 6 <br /> CONDITION # # # tt # # 6*0 # # It 9a.1 1/9il GR <br /> tt # # tf # tt # # # # �t x A # # # It it tt tt p o <br /> OIL_ & G!?EAStrVISUA REPORTED I�ga v� <br /> P ERMI T <br /> CONDITION * # # M It 9 # ;f It # li # # It +> # # It u # 10 1/90 VI <br /> REPORTED <br /> 3 <br /> try PERMIT .. <br /> itll CONDITION l <br /> REPORTED <br /> r <br /> 1` PERMIT <br /> CONDITION 4{ <br /> 3 NAME OF PNUICIPAL EXECUTIVE OFFICER TITLE OF THE OFFICER DATE <br /> I certify that I am familiar with the Inforoatlon onntainod in this <br /> report and that to the beat of my Anawledga and belief ouch infor- allR <br /> S J 6ttN1(EcuIYU� t1fCE e'i�arutu7 ?1�� motion Is frog complete,and accurate. SIGNATURE OF PRINCIPAL. EXECUTIVE <br /> y — <br /> LAST --FIRST MI TITLE YEAR MO DAY OFFICER OR AUTHORIZED AGENT <br /> 4 <br /> EPA Pora 3320-100.74 ORIGINAL PAGE 1 OF .1 <br /> 105 IS SETTLED MINE WATER FROM L,Se WOOD MINE 43 ANY SINGLE GRAB CANNO <br /> ( <br /> T EXCEEC 45 NG/L FOR TSS E, <br />