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PERMITTEE NAME/ADDRESS (include FadWy Nante/locarion if Differenri NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPDES) <br />NAME DISCHARGE MONITORING REPORT (D R) <br />ADDRESS _ :. .. <br />$0X f;2;_:, PERMIT NUMBER DISCHARGE NUMBER <br />A MONITORING PERIOD <br />FACILITY HORIZON MINE : YEAR MO DAY YEAR MO DAY <br />LOCATION -LA Cd FROM TO <br />I &mr r.: 1JAT1t~ . M T AIF MANAr- <br />MINOR <br />( SUBR <br />Form Approved. <br />OMB No. 2040-0004 <br />rIidTRS <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREOUENCY <br />OF SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT] <br /> PERMIT t tr k „ . r` F - .. , 2 <br />EPUR <br /> REQUIREMENT' UAILY f1X IIr ` <br /> SAMPLE i <br /> MEASUREMENT <br /> PERMIT 1 ft # a fi ? . P R ; rt ?. : r <br /> REQUIREMENT -GDA AVG L:F ' L•Y MX <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT REPUP; r <br /> REQUIREMENT OJT <br /> SAMPLE <br />JL_ V L, MEASUREMENT <br /> PERMIT t# .4-t ?y n ;r PL0. <br />F7 E t- U <br /> REQUIREMENT ;Jfi rt' " DA T L Y <br /> SAMPLE <br />_ MEASUREMENT <br /> PERMIT I UK <br /> REQUIREMENT D,-, I L , !"ONTr- <br /> SAMPLE _ <br /> MEASUREMENT <br /> <br /> PERMIT <br /> REQUIREMENT ...?. `"-? DAILY i"IX <br /> SAMPLE <br />. MEASUREMENT I <br />PERMIT r, <br />.REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I crrlir} under penalty of Iau that Ihi, document and all attachment, wrrr TELEPHONE DATE <br />pr<purrd under r? dirntioo or cupenision in o ardarwr With a +I?+tem designed <br />to u.+urr that yualiried perwmrcl proprrIi kathrr and r?aluate the information <br />+abmitled. Ifa+rd on m} inquire of thr per+na or prr,on+ who manage the <br />ti <br />th <br />l <br />h <br />i <br />h <br />i <br />f <br />f <br />ti <br />i <br />orma <br />r for gat <br />er <br />nr t <br />e <br />n <br />on, <br />e <br />n <br />orma <br />on <br />or th- parsons dim11) rr+ponsib <br />} ( wbmitl d 6. to the brsl of m% knowledge and brlief. true, acmratr, and compkte. <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />Y <br />' <br />TYPED OR PRINTED,' 1 am awarr that there are,ignirtcant penalties for mbmining false information, <br />inrludingthrposslbilinorrineandimpri+nnmrmforknowing violations. OFFICER OR AUTHORIZED AGENT AREA <br />DE NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLA I IONS fxererence an anacnmenrs nerel <br />EPA Form 3320.1 (Rev. 3199) Previous editions may be used. DOOE 1 • ; hWhra 4=0d*4drni. PAGE