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PERMITTEE NAME/ADDRESS ilndude Facility Name/Location if UifJerrni) <br />NAME <br />ADDRESS <br />"D 81639 <br />FACILITY -,A MINE COMPLEX <br />LOCATION ! EN CO 81639 <br />Y KARO, RECLAMATION MANAGER <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 D <br />FROM TO <br />Form Approved. <br />OMB No. *040-00040 <br />MINUR <br />(SUER JC) <br />F - FINAL <br />DISCHARGE TO GRASSY <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION N0. <br /> <br />EX FREOUENCY <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ' h <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER 1- rW, ender penalty of law that this document and all attachment% were <br />with <br />e <br />r <br />d <br />de <br />di <br />e <br />tio <br />o <br />s <br />e <br />visio <br />in <br />ord <br />st <br />m d <br />si <br />n <br />d TELEPHONE DATE <br /> pr <br />pa <br />e <br />un <br />r my <br />r <br />c <br />n <br />r <br />up <br />r <br />n <br />acc <br />ance <br />a sy <br />e <br />e <br />g <br />e <br /> to assure that qualified personnel prnperh gather and eraluate the Information <br />s <br />b <br />itt <br />d <br />Ra <br />d <br />in <br />i <br />s or the <br />r <br />wh <br />a <br />th <br />Ne I <br /> e <br />. <br />se <br />on my <br />qu <br />pers <br />m or perwns <br />o man <br />ge <br />e sy <br />u <br />m <br />r <br />m. <br />or those persons directly responsible for gathering the information, the Information <br /> submitted Is. to the hest of m% knowledge and belief, true, accurate. and complete. <br />w <br />b <br />it <br />I <br />th <br />t th <br />i <br />ifi <br />t <br />lti <br />i <br />r <br />i <br />i <br />f <br />f <br />i SIGNA RE OF PRINCIPAL EXECUTIVE ?? •, <br /> <br />TYPED OR PRINTED ng <br />are <br />a <br />ere are s <br />gn <br />can <br />pena <br />es <br />or su <br />m <br />t <br />a <br />se <br />n <br />ormat <br />on. <br />am a <br />Including the passibility of rtoe and imprhrmment for knowing slolatkm. <br />OFFI ER OR AUTHORIZED AGENT AREA <br />DE NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used. This is. a 4-pars form. PAGE OF