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PERMITTEE NAME/ADDRESS tlnclude facility NamelLocation iJIhffereul <br />NAME <br />ADDRESS 7 <br />FACILITY <br />LOCATION <br />F PRF <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMB No. 2040-0004 <br />F - FINAL DF-L i <br />MINE DRAINAGE rO GUNNISON RVR _x:ro, <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br />FREQUENCY <br />OF <br />SAMPLE <br /> <br />EX <br />E <br />X <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER I mrtifs under penalh of law that this document and all attactmwnts we" TELEPHONE DATE <br />prrpared under my direction or supenkion in accordance with a s)orm designed <br />to nmure that qualified personnel properl% gather and csalunte the information <br />wbmitted. Mused on m) mquin of the perm or peruoms who manage the gstem. _ <br />or those persons directl7 resprmihie for gathering the information, the information <br />_ nubmititA is, to the two of m% knowiedgr and helief. true. accurate. and complete. <br />SIGNATURE OF PRINCIPAL EXECUTIVE _ <br /> I am aware that there am signirwant penalties for submitting false information. AREA <br /> m-ibilits of nine and impriwmment ror knowing siolations. <br />ludin <br />the <br />i OFFICER OR AUTHORIZED AGENT I <br />NUMBER <br />ODE <br />YEAR <br />MO <br />DAY <br />TYPED OR PRINTED t <br />nc <br />g C <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />This-is a 4-part form.