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PERMITTEE NAMVADDRESS (/nd.fr FxNMry Nava Leca?,on (/D?irwee) <br />NAME r <br />ADDRESS <br />15, 1JOA :370 <br />.-PER UT 8452t <br />FACILITY !?GER CA1,,1Y!-1N 11INE <br />LOCATION :1A CO <br />`,.BID B. MILLER, BUSINESS M37R <br />NATIONAL POLLUTANT OfSCHMOE ELIMINATION SYSTEM INPDESI <br />DISCHARGE MONITORING REPORT IDMRI <br />PERMIT NUMBER DISCHAiOE NLOASER <br />MONITORING PERIOD <br />YEAR MO DJ1Y Y M D AY- <br />FROM TO <br />Form APProved. <br />MINOR OMB No. 2040-0004 <br />(SUBF !-oj <br />F - F I NAL GR F LJ) <br />SED POND DSCHG TO MUNGER CREEK <br />NOTE: Reed Irletrtlcdone before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, <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 /> - : , <br />+(.'0 PERMIT <br />i " L UE: iVT r <br />REQUIREMENT MINIMUM MAX IMUM <br />' SAMPLE <br />_ <br />I E:N ' ^ MEASUREMENT <br />It <br /> <br /> <br />t ?.ItO= • ^' - - PERMIT <br />REQUIREMENT 30DA I)A1 L ' i`SX <br />P: <br />T <br />F <br />2 <br /> <br />- `. <br />0 <br />1 - <br />E <br />- - <br />SAMPLE <br /> MEASUREMENT <br />J r <br /> <br />-J ,41 PERMIT <br />REQUIREMENT Mx IIDPlir <br /> <br /> SAMPLE <br />(AS FE- MEASUREMENT <br /> : . <br /> PERMIT " <br /> REQUIREMENT 30DA 1` ` C- =A I i_ <br />Y MX <br /> <br />_ SAMPLE <br /> MEASUREMENT <br /> <br />-.q2 1 O ) PERMIT <br />'ENT , REQUIREMENT INST MAX <br /> SAMPLE <br />TRFf?, ( ^d7 F: MEASUREMENT <br /> <br /> <br /> <br />. <br />i )ENT GROSS ' <br />PERMIT <br />REQUIREMENT <br />30DA AVG <br />-•> ILY MX <br /> <br /> SAMPLE <br /> MEASUREMENT <br />1 c? - 1 <br />PERMIT <br />REQUIREMENT <br />1 nrir y u tr pen. ly o ¦w th al this doevmell ¦nd W at larhmmu were NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />TELEPHONE DATE <br />prepared under my dim,tlon or wpen/slon In accordance with a tysi m dalfud <br />Io A> m that quallfled perumnal pmpeAy galher and e-lualt the Inforsnatlon - <br />/ ? <br />) G1( sabrdlled. Based on my Inquiry or the person or persons who manage the sywlean <br />.za <br />_ <br />l_ <br />tl <br />bbl <br />d <br />f <br />h <br />or most persons <br />irec <br />y respo <br />e <br />or fat <br />ering the Informatloo, the Information / <br />sabralll el hk to the beat 0(-Y knowledge and belw. trw, areunlt. and cow-pie". <br />nill <br />-? I <br />m <br />war <br />t th <br />l <br />ndd <br />F <br />b <br />lltl <br />I <br />f <br />SIGNATURE OF PRINCWAL EXECUTIVE <br />th <br />d <br />f <br />l <br />Nl <br />' <br /> <br />-- <br />- <br /> <br /> <br />TYPED OR PRINTED a <br />a <br />e <br />a <br />en an <br />i <br />can <br />pe <br />e <br />or m <br />m <br />ng <br />a <br />se <br />n <br />orm <br />on. <br />Inhaling the poodbtmy of flaw and Imprisonment For knowlnt elnlauonn <br /> <br />OFFICER OR AUTHORIZED AGENT NuMeER <br /> <br />AREA <br />CODE YEAR M <br />o D D <br /> <br />AY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS Re%rsncli ON sttschmsnts hsfs) <br />LEABLE SOL <br />IDS LMT APPL7=-D FOR <br />t=10YR, <br />24HR PRECIP EVENT, <br />- r-, , -'4HR E ,. P NT _ -- <br />1: i <br />. T 1• 2, <br /> <br />- ?' <br />? .'U d S Fi : ,!%W" DURNG PERI OD --S-MLC•. c i . ,. <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. this is a 4 -p ail form, PAGE OF <br />