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PERMIT-ME NAME/ADDRESS (In" far&er)VeaeWL«ar,.w (/D(dwwrr) <br />NAME <br />ADDRESS <br />box 483 <br />t-.;,0NIA CO <br />FAc;LrTY r LJ I E NO. 2 MINE <br />LOCATION ?N I A CO <br />LLIAM A. BEAR JR., MINI <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM /INPOESI <br />DISCHARGE MONITORING REPORT (DMR1 <br />PERMIT NUMBER DISCHARGE NUMBER <br />1 ?+ <br />MONITORING PERIOD <br />Y A D [YEAR O DAY <br />14, FROM TO <br />MG r; <br />Form Approved <br />OMB No- 2040-0004 <br />MINOR <br />(SUBR MH) <br />F - FINAL <br />DSCHG OF SI <br />DELTA <br />UNNISON RIVER <br />NOTE: Rood Instructions Wore completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION <br />NO. <br />PREOUENCY <br />of <br />SAMPLE <br /> EX TYPE <br /> ANALVSts <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE r...:_ <br /> MEASUREMENT <br /> PERMIT ,, <br />INSITU, <br /> REQUIREMENT M I N I MUM MAXIMUM <br /> SAMPLE <br /> <br /> MEASUREMENT <br /> PERMIT ##ztsa ##3i#s: f *****-0 _. 70 <br /> REQUIREMENT 30DA A')G I;, ;'_.'r' MX ^.13i ; F; <br /> SAMPLE <br /> MEASUREMENT <br />7 0 PERMIT iF #3F ii #lF h,= ... iFitdFiF#i <br />REPORT <br />REPOR7- r.:; <br />t <br />-C- REQUIREMENT 30DA AVG DAILY MX h101'v <br />.P(j <br />3S <br />;,_, <br /> SAMPLE <br />FE; MEASUREMENT <br />i. O PERMIT # iF#dE# r ####iF# j•.J:,t 6000 <br />-r= <br />!_UENT GRQ?}`_ REQUIREMENT -!ODA AVG DAILY MX MONTH <br />1 U -A. i SAMPLE <br /> MEASUREMENT <br /> PERMIT ON : j : t <br /> REQUIREMENT ii?IST !`;AX I=EP'}T <br />_ '• .Jt _ SAMPLE <br />i N71 NT MEASUREMENT <br />7 PERMIT REF 04•. <br />_;ENT REQUIREMENT 3,7DA DA I L Y N X <br />r,.:.. SAMPLE <br /> MEASUREMENT <br />PERMIT -f _ - _ , - ,- - t <br />REQUIREMENT : M1liY MA X <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER I Certify ° r Penalty o Is. -,het i fH dorumenl and all ¦ttathrrterttl wen TELEPHONE DATE <br />trepan" coder my direction or suPerv4don In sccoedence with ¦ system ddtned <br />to men t qu.Nned P.noneel P-Prrtr Lather and ee.lu.te the Inrorm o." <br />ssbmlltee. /ased on my Inquiry of the Person a Persons who m.n.Ee the system. <br />tl <br />res <br />onsible For <br />atherln <br />the Inronnatton <br />llee Inrormatlen <br />di <br />th <br />y <br />p <br />N <br />, <br />or <br />ane penons <br />rec <br />t <br />submitted Is. to the best or my hnaerledIt and beW, Ire., accurate, and tomp*t.. <br />SIGNATURE OF PRINCIPAL EXEClIT1VE <br />- <br />• <br /> 1 am swan that then an d&ncant peeishin For submitting rates Inroemadon, AREA <br />TYPED OR PRINTED Indudtn? The Possibility of nn. and ImprIsonmrnt for hno.tnE elei.lbees. OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO OAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Reference sit ettechment: here/ <br />; 'I-tR PRECI P EVEPIT rc Cl.A£MED. £E' CL ATM APPROVED BY WGCO, <br />i-?ASUR EME-,. f ;; <br /> <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. Tt u; js,a 4-part form. PAGE OF