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PERMITTEE NAMEIADDRESS {include Faci6ls.Vamr/!"oration if Ufferentl <br />NAME <br />ADDRESS <br />'X 6_70 <br />CO B1635 <br />FACILITY _ MINE COMPLEX <br />LOCATION r E, N C LI 816315 <br />1Y V RO: RECLAMfiTION 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 DAY <br />FROM TO <br />Form Approved. <br />OMB No-J040-0004 <br />MINOR <br />(SLIBR .)C) <br />F - FINAL R OU <br />DISCHARGE TO SAGE CREEK <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br /> <br />EX OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE ri <br /> MEASUREMENT j <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br />l <br /> MEASUREMENT f -- -? - <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 I certif.s under prnah% of htw that this document and all attachments were <br />e <br />ared under <br />t dir <br />ti <br />%k <br />d <br />ith <br />t <br />d <br />i TELEPHONE DATE <br /> pr <br />p <br />m <br />ec <br />on or caper <br />ion in amor <br />anee w <br />a - <br />ern <br />es <br />gned <br /> to assure that tluahrMf personnel properly rather and es'aluate the information <br /> -hustled. Baud on my irutitir) of the petwn or persams who manage the.istem. <br />or 1ho.e Wrnona direcU? re,iwatsiMe for gathering the information. the information r <br />j <br /> suhmitkr) is, to the hest of me know Wtr And hetief. true, accurate. and romplrte. <br /> I am ..are that there are signifA.nt prnAhies for submitting false information SIGNA URE OF PRINCIPAL EXECUTIVE <br /> . OF CER OR AUTHORIZED AGENT AREA <br />TYPED OR PRINTED including the p-ihility or fine And tmpri-runent for km,%ing si,dation.. NUMBER YEAR MO DAY <br />COMMENTS ANU EAI'LANA I SUN US- NT VIOLA I IUN, (HererenCe all arfacnmentS here) <br />'-Tr^T T' APFI_IFr) F^47 =1n,P. 74Nf'" ^_p-I'TP T7VI_."IT. TSS, <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. This is a 4-part-form. PAGE -OF