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PERMITTEE NAME/ADDRESS (include Faci6rr A'mae/Location ijDifJerent) <br />NAME <br />ADDRESS <br />50X 670 <br />'DEN Cl, ©163 <br />FACILITY ,ECA MINE COMPLEX <br />LOCATION DEN t': U 9163 <br />f KARO, RECLAMATION MANAGER <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />FROM YEAR MO DAY TO YEAR MO DAY <br />Form Approved <br />OMB No. ap4O-"b <br />F ^ FIf <br />D i SCIIAf <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, <br /> <br />EX FREQUENCY <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br />MEASUREM ?I <br /> ENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT .; r> <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT j <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT } <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I . luk under iwoali% of law that this d-umenl and all attachments werr <br /> <br />d <br />ti <br />with <br />t <br />i <br />d <br />di <br />i <br />i <br />i <br />d <br />d <br />d <br />TELEPHONE <br />DATE <br /> prc <br />pure <br />un <br />er m% <br />rec <br />on or +upen <br />on <br />n -r <br />em <br />s <br />amr <br />a sys <br />es <br />gne <br /> to assure that qualified personnel properly gather and rsaluate the information <br /> submitted. !lased on my inyuin of the person or persures who manage the system. <br />or [how prtSons dirndls responsible for gathering the information, the information .. <br />/ <br /> submitted is <br />I. the best of mi knowledge and belief <br />true <br />accurate <br />and cumpiete l <br /> , <br />. <br />, <br />, <br />. <br />I am aware that them are si <br />nifkant <br />enalties for submittin <br />lse information <br />f SIG TUBE OF PRINCIPAL EXECUTIVE ? <br /> <br />TYPED OR PRINTED p <br />g <br />g <br />a <br />, <br />including the posibility of fine and imprisonment for knowing+iolations. <br />O FICER OR AUTHORIZED AGENT AREA <br /> <br /> <br />NUMBER <br />CODE <br /> <br /> <br />EAR <br /> <br /> <br />O <br /> <br /> <br />AY <br />UUMMtN IJ AIVU tAYLANAI IUN Ur ANT <br />(rrererence an arracnmenrs nere/ <br />T . A REASONABLE POTENTIAL. ANALYSIS BE <br />EPA Form 3320-1 (Rev. 3!99) Previous edrtlons may be used. `,C)% ' This -is a 4-parf`•fArm.