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PERMITTFE NAMUADDRESS17iw6iF.rtbryNwrrL -vi-(/DO6w ) <br />NAME <br />ADDRESS <br />-0NIA CO 8142 <br />FACILITY . IW I E NO. 2 MINE <br />LOCATION` AONIA CO 8142 <br />'JILLIAM A. DEAR JR.: MINE MGR <br />NATIONAL POLLUTANT OISCHAROE ELIMINATION SYSTEM NPOES) <br />DISCHARGE MONITORING REPORT IDMRI <br />PERMIT NUMBER DISCHMOE NUMBER <br />MONITORING PERIOD <br />YEAR I O DA Y O D 4Y <br />FROM TO <br />Form Approved. <br />OMB No. 2040-0004 <br />MINOR <br />(SUAR MH) <br />F - FINAL 1 <br />WWTF TO DEER TRAIL DITCH <br />NOTE: Read kwit uctione before completing thlD form. <br /> <br />PARAMETER <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. EOUENCY <br />SAMPLE <br /> <br />EX of <br />r <br />TYPE <br /> AmALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE a:- <br /> MEASUREMENT _ <br /> PERMIT ### tFt ; ii # t x ?r##ii # _. <br /> REQUIREMENT 10DA AVG MX 71) AV MONTH <br /> <br /> SAMPLE <br /> MEASUREMENT <br />tJ PERMIT # It # lf# r , , 74=7- <br />l'. u <br />=R <br />D' REQUIREMENT 30Di? r'.'.'i- MX 7D AV MONTH <br /> SAMPLE L <br /> MEASUREMENT <br /> PERMIT rr = :. a V.0 4 c ., t i ... <br /> REQUIREMENT M I N L M UN 1 MAX I MUM <br /> <br />' SAMPLE <br />%F K1 MEASUREMENT - <br /> PERMIT <br />J I NF L_UEF REQUIREMENT 30DA AVG MX 7D A{/ 1901 X r i-i <br />IUIAL SAMPLE <br />Lc_D MEASUREMENT <br />t?053Q 1 0 PERMIT _ : ;;-:_ <br />Er if Pi ?RO?:'_ aA REQUIREMENT "$-ODA A.'(,: I-I*X 7L AV I'!TH <br /> SAMPLE <br />MEASUREMENT <br /> <br />1 U PERMIT ,. <br />77. .... <br />x - <br />i <br />):ENT GROE?D ': - REQUIREMENT NST MAX t <br />11, r 1 1. SAMPLE <br />;,L:; ?.! i 'O EATMENT ° • I MEASUREMENT <br />n PERMIT T: , .. <br /> REQUIREMENT ?")DA AV(- DAILY MX UOUS <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER 'rent a r pen. ty o a. shat th is document and II ¦tiachments wen TELEPHONE DATE <br /> prepared refer my dln•ction or supe rsisfon In accordance with a system designed <br /> to assure that qualified personnel Property gather and traluate the Information <br />subrilled. Dowd on my Inqulry of the person or Persons who manage the system, <br /> or those persem directly responsible for gathering the Information, the Inforrrtion - <br /> submitted K to the best of my kmwledgt and beW, true, accunle, and complete. <br /> I am aware that then are signllkant penaitks rot submittin <br />rat. Inrormatlon SIONATURE OF PRINCIPAL EXECUTIVE <br /> g <br />, <br />TYPED OR PRINTED ffk- Wing the possibility of fine and imprisonment for knowing .lol.tlo- OFFICER OR AUTHORIZED AOENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EAMAMA I tun yr nn r vwl-n i ivna frferprenc• an srrscnmmra nsrsf <br />INSTRUCTIONS - I.C <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. <br />PG. 10. <br />00327 /OT.ttiCUa 4-¢ad Corm.