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NATIONAL. POLLUTAII r WC.14ARGE F-LiMINA I 10N SYSTEM <br /> DISCHARGE REPORT <br /> -vt,, Jti,q J.) <br /> A <br /> F <br /> Wp <br /> x 1SR <br /> INSTRUCTIONS <br /> 1. Provide dates for period covered by this report In spilc,!s nimf-d"REPORTING PEW OW'. <br /> 2. Enter reported minimum, average and maximum valiser, under"A',I j A NTITY"and"CONC I.Wfl2 A T K)W, <br /> 42-31 in the units specified for each parameter as t,pproiitim . W, v,,l -1- in 6--; <br /> -- asterisks. AVERAGE" is average computed over limn +!i i:; <br /> are observed diirin)t 1he 1. <br /> and"MINIMUM" extreme values obs <br /> 0 3 q 11 1211 1 Specify the number of <br /> analyzed samples thiii ex--1 11w-txjj.ia:;.......:,'n ?,,.r-,un,a. <br /> PERMIT NUMBER is — permit conditions in the columns labeled"No. E'x.- It not-, -w, '0". <br /> SIC LATITUDE LONGITUDE 4. Specify frequency of analysis for each paraniet"--14"' -1-1" '1;'l "J/7- i,; eq.iva- <br /> tW-al) 129-23) 424-251 126.271 120-291 430-411 tent to 3 analyses perlonned every 7 days.) If c,-ntjnw-n unt, WiT." <br /> S. Specify sample type("grab"or"—hr. compo N i to")as If frefillf-c",was continuous, <br /> I enter "NA". <br /> REPORTING PERIOD: FROM TO 110 6. Appropriate signature Is required on bottom of lics(ono. <br /> YEAR MO DAY 7. Remove carbon and retain copy for your records. <br /> CA YEAR MO I DAY 6. Fold along dotted lines, staple and mail Otifi.al <br /> 152-37) <br /> (3 cord ailly) QUANTITY card only) <br /> CONCENTRATION <br /> PARAMETER 438-45) (44-031 41141-611 (62-63,138-451 4.6-53) to 4.0 1) SAMPLE <br /> MINIMUM AVERAGE MAXIMUM UNITS 110, -1 1[j i X MINIMUM AVERAGE MAXIMUM UNiTS ANALYSIS Tl'PE <br /> REPORTED 0 O.uW 0-1Z <br /> MGD <br /> C7 PILWAl T <br /> CONO.110N 7 <br /> Alt--S, T-ITAL nt -S REPORTED it a 4� 111 333u ii if Ik V <br /> KG/DAY <br /> PLWAiT it is <br /> If !i yu <br /> I� ( - CONUI TION <br /> REPORTED <br /> KG/DAY <br /> it <br /> CON01 T!.N 30 <br /> OTA 1. 45 F f' REPO RTEO iF it # # A ii # # It 0.0 Ily <br /> KG/DAY ---- <br /> 7 C ONO$T I ON it 4 105 7. C..1 <br /> L L REPORTED 0 it 4 It It it <br /> u S C_lj <br /> CONDI TION 60 <br /> I L h GI�Fc"=;F,VIc!Ui.( nepoRlEo G it # # # a 4 1A, it <br /> C- <br /> PEwm r <br /> CONDI TION It it # 9 It It # u t li i 1/ ;, V1 <br /> FR LP 0 R T 0 <br /> CONDITION <br /> 0 PERMIT CON01 TION <br /> l---L <br /> NAME OF PRINCIPAL EXECUTIVE OFFICER TITLE OF THE OFFICER DATE <br /> I certify that I am familiar Will the infonnallon containe <br /> d C, la di <br /> Jl;( <br /> report and that to e beat of my knowledge and belief such inter- <br /> mation is true, complete$and accurate. SirMAIURE OF rIIPAL EXECUTIVE <br /> LAST FIRST P 14CMI J TITLE DAY OFFICER OR AUThORIZED AGENT <br /> EPA Film,3320-100.72) PAGE OF <br /> ORIGINAL <br /> Sf *!* -I-FD 1-411W WATER FROM S. WoOO MINE 43 ANY SINGLE GRAB CANNO <br /> T W-, !'G/L FoR TSS <br />