1987-12-01_PERMIT FILE - C1981017 ‎(262)‎

• Permit No: C1981017
• IBM Index Class Name: PERMIT FILE
• Doc Date: 12/1/1987
• Doc Name: Mine Discharge Monitoring Reports
• Section_Exhibit Name: Chapter III Appendix III-E-4
• Media Type: D
• Archive: No

I' NATIONAL POLL.UTAN•.HARGE ELIMINATION SYSTEM .•
DISCHARGE MuNiTORING REPORT Form Approved
i
OMB NO. 155-MO73
f F
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eA-9 Qoru DR-LE:
3
GO 8!6 2 3 INSTRUCTIONS
i I. Provide date&for padud covared Ly this report in spaces marked"REPORTING PERIOD".
1 J 2. Enter reported minimum,average and maximum values under"QUANTITY"and"CONCENTRATION"
jj I2-s Ld-Im uT-1a1 In the unite specified for each parameter as appropriate. Do not enter values In be Xea containing
.i asterisks. "AVERAGE" is averrga computed over actual time discharge is operating. "MAXDAUld"
a o ors 3 q 6 0/ 2J and ityIthe nu"are extreme values le observed during the reporting period
` i Specify the rumhar m(analyzed samples that attceed the maximum(end/or minimum as appropriate)
per^ilt conditions In thi columns labeled"No. Ex." if none, enter"O".
ST PERMIT NUMBER DIS SIC LATITUDE j LONGITUDE
4. SFerify frequency of analysis for each parameter as No. anelyees/No. days. (e.g., "3/7"is equiva-
120-a1) 122.251 124-26I (28•27) (20•201 ISO-all lent to 3 enalysea per(Onned every 7 days.) It Continuous enter"CONT."
i S. Specify sample type("grab"or"_hr. compnaite")as applicable. If frequency was continuous,
a 7 enter NA".
REPORTING PERIOD: FROM 7 d ` �I TO 7 � Q � � � 6- Appropriate signature is required On bottom of this form.
YEARI MO DAY YEAR I MO I DAY 7. Remove cWoor,and retain copy for your records.
8. Fold along dotted lines, staple and mail Originsl to office specified to permit.
saan
(3 raid oily) QUANTITY v- (I c dd only) CONCENTRATION
• '? 12e-+m 1M-ell larell __- �• q2-er i2a.dm l+a•eM _ to+-eu rez•er FAh:UUENCY SAMPLE
r PARAMETER ------- ----- OF
MINIMUM AVERAGE MAXIMUM UNITS EX MINIMUM AVERAGE MAXIMUM IINIT•6 NO' TYPE
EX ANALYSIS
REPORTED -
:j I
PERMIT
CONDITION
.} REPORTED -
PERMIT '
CONDITION
i REPORTED
}
' PERMIT
CONDITION i
REPORTED
P ERMI T
CONDITION
1 - _ --_-- REPORTED
PERMIT - i _ Ak
_�
CONDITION
`7 REPORTED - --
PERMIT
1 Co N01 TION
REPORTED
PERMIT
CONDITION
! REPORTED
PERMIT
CONDITION
NAME NAME OF PRINCIPAL EXECUTIVE OFFICER TITLE OF THE OFFICER OATe
f certify that(am familiar with the information contained in thta t
) ,C� _ .EX. CI-' /1"C /��' � 7 repo``and/her to the 6aef c1 my knowledge and baits(such Into`-<-_� _--• t_t_ r. _ motion is true,complete,and accurate. SIGNATURE OF PRINCIPAL EXECUTIVE
LAST FIRST NI TITLE YEAR MO OAY OFFICER OR AUTHORiZEO AGENT
EPA Form 3320.1(10.72) --
PAGE OF
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ORIGINAL