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NATIONAL POLLUTANT DISCHARGL ELIMINATION Sys-rr-tA <br /> • DISOIARC WITORING REPORT <br /> INSTRUCTIONS <br /> 2. Provide dates for period covered by this report in spaces""It!-I P01"i ING <br /> 2. Enter reported minimum, average and maximum values underj'i <br /> Z-3) 14-101 417.101 in the units specified for each parameter as U,, not Aof- -I,-,in I,- !it, <br /> asterisks. "AVERAGE" Is average conipuled over t-tual li'-, 0: i!--1 I:; '-p-ah"g. <br /> and"MINIMUM" <br /> 'MIN I IIIUM" are extreme values observed during the,-1-:1;:w i(,,I. <br /> 3 9 [�2 1] 3, Specify the number of analyzed samples that exceed 11j,i I"" ;,j"j.�,m,as <br /> permit conditions in the columns labeled"No. Ex." If nor-, 1,7 o". <br /> E-1,,-PERMIT NUMBER S LATITUDE LONGITUDE <br /> 4. Specify frequency of analysis for each pararnetc, as No. da%�. "317- 1, <br /> IZD-211 (22-431 424-26) 126-27# (25-201 (30-310 lent to 3 analyses performed every 7 days.) If Continuous "I I I!!l.", <br /> S. Specify Sample type("grab"at"—hr. composite")as frequency WE., <br /> enter "NA". <br /> REPORTING PERIOD; FROM TO I 1 6. Appropriate signature is required on bottom of[his form. <br /> TI�A R MO DAY YEAR M- DAY 7. Remove carbon and retain copy for your records. <br /> 8. Fold along dotted lin.s, staple and mail Original to office m+•I in p-wil. <br /> 432.371 (3 card only) <br /> QUANTITY (4. d..)y) <br /> CONCENTRATION F P COLI Eli CY <br /> PARAMETER (02-03!4 36-:1, 146.53) OF T_-._..____1 <br /> 11NO.MINIMUM AVERAGE MAXIMUM UNITS I MINIMUM AVERAGE MAXIMUM UNITS ePE <br /> EX I ANA L YSIS <br /> I REPORTS0 if iF <br /> P914.1 T <br /> 7.; ft <br /> C,.': <br /> CONDITION If tf it 0 6 it a <br /> 9 n155 REPORTED rt It 0 0 it U <br /> KG/DAY <br /> S 1.V . ........ <br /> PERMIT <br /> CONDITION 4 » It # it It il ii <br /> If <br /> L?Lj CI REPORTED0 <br /> I Tf•L <br /> PERMIT Y <br /> it If IF <br /> CONDITION 4 <br /> kw <br /> 10T f%I(A ; F;-) REPORTED V <br /> 1) — / I/,* * <br /> PERMIT nut'1 <br /> CONDi TION U it <br /> 7.o <br /> PERMIT <br /> It LO REPORTED it It if <br /> C f it it 0 It <br /> O"DITION <br /> -VVVS041, REPORTED a » If it it 4 <br /> P 9 NMI T :I If #1 34 If It it if # It <br /> CONDITION <br /> PERMIT C 0 N D I T.ON <br /> REPORTED PERMIT <br /> CONDITION <br /> NAPAE OF PRINCIPAL EXECUTIVE OFFICER TITLE OF THE OFFICER DATE <br /> certify that I am familiar with the Information contained in(]Its <br /> -Gr -5 tewtv F <br /> report and that to the best of iny knowledge and bullet such infor- <br /> [WC motion ill true, complete, and accurate. SIGNA10Pr OF PRINCIPALExrurtive -I <br /> LAST FIRST M1 TITLE YEAR MO DAY OFFICER ON AU tHORIZE11 A(j <br /> EPA IF*-3320-100-72) PAGE OF <br /> 0'� 1,". ';F-TTff0 kPIF :+14TER FROM eF AR CREEK MINE ANY SfNGLE GRAB CANNOT ORIGINAL <br /> ':'XCEF0 45 -16/L. F'1� TSS <br />