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NATIONAL POLL UTAN7 ARGE ELIMINATION SYSTEM <br /> �. <br /> pyrove.d DISCNARGEWTORING REPORT <br /> r ti,:D—CT CWtL (PREP PLANT <br /> i <br /> PO HOX 15s <br /> { <br /> ? CAP9CNr'ALE INSTRUCTIONS <br /> 1. Provide dates for period covered by this report in otrucas marked-n EP0kTING PERIOD". <br /> LCO 916?_3 J 2. Enter reported minimum, average and msain,,.n values under"QUANTITY"and"CONCENTRP_TSON" <br /> in the units specified for each paraneier as appropriate. Do not enter values in boxes containing <br /> ix v tw lm III-to) <br /> �+ I asterisks. "AVERAGE" is average computed over actual time discharge is operating. "MAXIMUM" <br /> and"MINIMUM"are extreme values observed during the reporting period <br /> t', 1 0000396 —_ (ti 1'�—I11 3 Specify the number of analyzed samples that exceed the maximum(and/or minimum as appropriate) <br /> C_:— permit conditions in the columns labeled"No. Ex." If none,enter"O". <br /> 'ofST PERMIT NUNBEA t DIS SIC LATITUDE LONGITUDE 4. Specify frequency of analysis for each porametar us Nu. analyses/No. days. (e.g., "3/7"is equiva- <br /> lent to 3 anelysea performed every 7 days.) If continuous enter"CONT." <br /> Izo-zD Ixz-xR Izazm Ize-xn tze•xal 13o-au <br /> { S. Specify sample type("grab"or"—he. composite")as applicable. if frequency was continuous, <br /> eater "NA". <br /> is REPORTING PERIOD: FROM t� 1 TO 7f3 I 1 6. Appropriate signature is required on bottom of this Corm. <br /> I YEAR MO DAY YEAR MO DAY 7. Remove cotton and retain copy for your records. <br /> 1, S. Fold along dotted lines, staple and mail Original to office specified in Permit. <br /> a iez-3T1 _ 1e4-ee1 '(ea•Ta) <br /> S� (3 card only) �(0 card Doty) <br /> IF QUANTITY CONCENTRATION FREQUENCY <br /> { PARAMETER _ 138-eel IN•a31__ _—_IaMeN—_ ._�,_.—TeN011 laa•iM1t —_, --116•aal roaen _ INDe3 OF SAMPLE <br /> MINIMUM AVERAGE MAXIMUM UNITS Ex MINIMUM AVERAGE MAXIMUM UNITS Ex ANALYSIS TYPE <br /> f hi-;)ter IN C011'iUIT REPORTED # fF # # # t•: # # # # # <br /> M70 t 06D <br /> PERMIT <br /> CONDITION 1/7.—— <br /> ---_ � IN <br /> � 5'_'L IDS r TGTAL DI..0 S REPORTED <br /> ( I SSC'LVc t:�) v KG/UA.Y MG/L <br /> coNo rlloN # # # # # p # # # # �► # # # # # # I # # # # 1/90 GR <br /> 1GS9 TOTAL SUSP REPORTED <br /> -- - <br /> K 3 .Y / Mfi <br /> PERMIT <br /> 4 t r r tr 30 1/90 CO <br /> COiv OI TION <br /> 't REPORTED # # # # # # fi .� <br /> ?0%4sT0TAL(AS FE) <br /> Kf3/DAY _ ry MG/L ------ _._r�_r <br /> G PERMIT # # # # #. ?Il # # # ti # t # ?{) Ie•i I/�)I) l.0 <br /> . 1 S%I j4E GON DI TION t <br /> • ,� REPORTED SL # # N # # ♦V # # # # # # # <br /> Prill IE.LD <br /> f PERMIT .._._._ SU A _ Su <br /> 4`-;i CONO.1.0" <br /> # r # » tr �r k p ` F n # sr # 9.0 1/90 GR <br /> �,IL GRELSEtVISUAL REPORTED <br /> 1 <br /> PERWT <br /> I <br /> 5J '2 CONDITION # # Y # +► St G # # �} # if # # # # # # # # 10 1/90 VI -- <br /> REPORTED <br /> ( I i <br /> PERMIT <br /> CONDITION __A__ __ _._- _—• - <br /> REPORTED <br /> i PERMIT <br /> i <br /> { GON LI TION <br /> .. NAME OF PRINCIPAL EXECUTIVE OFFICER TITLE OF THE OFFiC:.R DATE <br /> I certify that I am famNiar with the Information contained in this <br /> JfL/i/ 9kr1WC U7'I✓ia VICZ la-FaT tepott aid that to the best of my knowledge and ballet such infor- yc•• <br /> 1-1,_ motion is true, complete,and accursts SIGNATURE OF PRINCIPAL EXECUTIVE <br /> LAST FIRST MI TITLE YEAR MO DAY OFFICER OR AUTHORIZED AGENT <br /> EPA Form 3320.1(10.721 PAGE OF <br /> ORIGINAL I I <br /> 0013 IS SETTLED MINE WATER FROM L.S. WnOD MINE #3 ANY SINGLE 6RA.t3 CANNO <br /> j T EXCEED 45 OG/L F',,)P TS5 <br />