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PERMITTEE NAME/ADDRESS pncis& .ewgN..?Lorr,cn l/D(dar.nr) NATIONAL POLLUTANT OISCHMOE ELIMINATION SYSTEM NPOES) <br />NAME DISCHARGE MONITORING REPORT (D R) <br />ADDRESS. <br />BOX 4& PERMIT NUMBER DISCHARGE NUMBER <br />.-I A MONITORING PERIOD <br />FACILITY I E NO. 2 MINE YEAR MO DAY YEAR MO DAY <br />LOCATION N I A C U 81 FROM TO <br />T : . ; i LL I AM A. BEAR JR. , MINE M( <br />MINOR <br />(SUBR MH ) <br />F - FINAL <br />;DEER TRL DTC <br />Form Approved. <br />OMB No 2040-0004 <br />'LTA I' <br />NOTE: Reed Irmtrucdom before complet" thte form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br /> <br />EX FREQUENCY <br />OF SAMPLE <br /> <br />Y <br /> ANALYSIS PE <br />T <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT t. y ; . ; .. <br /> REQUIREMENT <br />. <br /> N ) i <br />J! <br /> SAMPLE <br />MEASUR <br />T <br />M <br /> E <br />EN <br /> PERMIT t <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT tE 3? .? :: r , : l ., c <br /> REQUIREMENT ?. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT t + # #.,: jf. t?## #? <br /> REQUIREMENT '. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ## k t. k... ;. # ac ?. <br /> REQUIREMENT <br />Ow SAMPLE <br />Ff MEASUREMENT <br /> PERMIT O <br /> REQUIREMENT (LY i ;. <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />I F <br />I n , y ¦ nd? penalty *(6. that this document and all attachments very <br />TELEPHONE <br />NAME/T1TLE PRINCIPAL EXECUTIVE OFFICER <br />DATE <br />prepared under my cil-tton or super+!!on Inwcod <br />eancewith • systemdesigned <br />to asset" that qualtfled personnel properly gather and eeah,ate the Information <br />submitted. bawd on my Inquiry or the pens, or persons who manage the system. - ^ <br />.? or those persons directly respoMbir for gathering the Inforenatlaw, the Infonrrtion <br />submitted h, to the beat of my knowledge and beYef, Inse, weserste. and complete. <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />I ¦m s <br />n th <br />t the <br />n <br />i <br />ifi <br />t <br />itti <br />f <br />bl <br />I <br />ltl <br />f <br />b <br />f <br />t <br /> a <br />wa <br />n a <br />s <br />gn <br />can <br />pena <br />es <br />or su <br />m <br />a <br />e <br />n <br />ng <br />orma <br />ion, <br />TYPED OR PRINTED Including the potsiblllty of line and Imprisonment for knowing ytatath,na OFFICER OR AUTHOR12E0 AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS <br />SETTLEABLE SOLIDS LIMIT APPLIES ONLY IF C=10YR,24HR PRECIP EVEN- IS CLAIMED. IF CLAIM APPROVED BY b <br />TSS & IRON LIMITS WILL NOT BE APPLIED TO REPORTED MEASUREMENTS-SEE I.A,3, PP 4-5 FOR BURDEN OF PROOF <br />1 . t, I'tV Y. <br />EPA Form 3320.1 (Rev 3199) Previous editions may be used LYr: 1 rt!_ T ,:-W;r L J. 1,414 114.3 t z j%n I L This t rrv? a is a 4-part form. PAGE OF <br />?