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PERMITTEE NAME/ADDRESS iinclude Facility \amell.xation if Di ferenr) <br />NAME <br />ADDRESS <br />BW 670 <br />DEN CO 61639 <br />FACILITY =CA MINE COMPLEX <br />LOCATION U EN CO 81639 <br />Y' KARO, RECLAMATION MANAGER <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGENUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO I Lf <br />Form Approved. <br />OMB No. W40,004a <br />MINOR <br />(EUBR JC) <br />F - FINAL ROU1- 11: <br />DsCHG TO TRIO/HUBBERSON GULCH ? <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 1 <br />J ,• <br />` ?. <br /> MEASUREMENT ( <br /> PERMIT t <br /> REQUIREMENT L• " <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT J 1 <br /> PERMIT k <br /> REQUIREMENT ?•,:', L <br /> SAMPLE - <br />J <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> <br /> MEASUREMENT 1 <br /> PERMIT r- • .. L.L , <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT l <br />r -I PERMIT t <br /> REQUIREMENT `•?' _. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I certif% under penults of law that this document and all attachments avert <br />prepared under ns) direction or su <br />er%Kion in acrordunce with a + <br />•+tem dei <br />n <br />d <br />/? TELEPHONE DATE <br /> p <br />} <br />g <br />e . <br /> to aswrc that qualified perwnnel properly gather and esaluate the information <br /> submitted. Rased on mis inquire of the person or prrsons who manage the system. <br /> or those person, dirrd % respmsibie for gathering the information. the information s - <br /> suhmitted is. to the hest "I'm, knowledge and belief, true, accurate, and complete. <br />I atn aware that Ihere are significant <br />enalties for suhmNtin <br />raise information SIGN RE OF PRINCIPAL EXECUTIVE <br /> <br />TYPED OR PRINTED p <br />g <br />. <br />in, luding the p-%ibiln, 4 rive and impriwnment for knowing %i• lulkm%. OF ICER OR AUTHORIZED AGENT AREA <br />ODE NUMBER <br />YEAR <br />MO <br />DAY <br />IeVMMCpf 1 A N191J r-ArLAMPAA I IVI9 Vr A1Y T v,uLfi t tvtva Ine,erence ant aftacnmenis nerel <br />00167 ` This is a4-part form. <br />EPA Form 3320.1 (Rev. 3/99) Previous editions may be used.