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PF.AMITTEE NAME)ADDRESS(7^,"Fw+bry)v.-?l"wi.IJD(6i. )a <br />NAME <br />ADDRESS <br />:x7131 STATL HIGHWAY 12 <br />MEEKER CO 81 <br />FACILITY D1_OWYO MINE <br />LOCATION ' -K ER CO 8i <br />_LLY L). SANDERS, VP OF OPS <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPDESJ <br />DISCHARGE MONITORING REPORT (D R) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY Y DAY. <br />FROM TO <br />Form Approved <br />MINOR OMB No 2040-0004 <br />t ?UBR JC ) <br />F - FINAL <br />SEC 16 POND TO GOOD SPRING C.H <br />NOTE: Read Instructions before completing " form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREOUENCY <br />SAMPLE <br /> EX OF TYPE <br /> ANALfSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE , . <br /> MEASUREMENT <br /> PeRMIT <br />5 Vl',I- .!` REQUIREMENT <br />MINIMUM <br /> <br />- <br /> SAMPLE <br />SUSPENDED MEASUREMENT <br />:?0530 <br />PERMIT _ _ . <br />EFFLUENT <br />REQUIREMENT DE-1A <br />. ?, SAMPLE _ <br /> MEASUREMENT <br />_ <br />JbSi} a t :) PERMIT .. _... <br />`?FF'LUENT 07R SS VAL?.It REQUIREMENT ?'? <br /> SAMPLE <br />= OT AL RE.C tRAr'L- . MEASUREMENT <br />` • S: r, : ; PERMIT <br />FF' U; ;•iT C-k?)c r? :.. <br />REQUIREMENT '?.?T_?F IL.Y M-- <br />- AND 1Vtf!A!jr SAMPLE ... <br /> MEASUREMENT <br />13582 i C.' 0 PERMIT <br />E FF"LUENT GROSS REQUIREMENT <br />- - ?' SAMPLE <br />HHU TRFATMEN r MEASUREMENT <br />"C'O i C PERMIT <br />- -LUENT GRO:.-`. REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />AEQUIREMENT <br />I mmely u r pens ly o low that this document and all ati-hmenU Mere TELEPHONE <br />NAM /TITLE PRIM IPAL EXECUTIVE OFFICER <br />tl <br />r <br />e <br />+i <br />t <br />ith <br />d <br />i <br />I <br />d <br />t <br />d DATE <br />on or t <br />p <br />r <br />s <br />on <br />n seeor <br />a sys <br />em <br />prepared under my dime <br />anre w <br />es <br />gne <br />f! 71 -7 ' to lane that qusNMd personnel property pthee and r•atuste the infnrmsUon <br />fubmimd. Bred on my inquiry of the person a persons who rnawage the system. <br />or those persons directly rerpomlble fix tatheefng the Informatlon, the Informatlon t II i , <br />/ <br />??? .'? r i •/ r'! I wbmlued b, to the best or my knew4dge and better. teas. steurate, and toenpkte. - -- <br />(- / <br />???' <br />SIGNATURE OF PRWCMAI EXECUTIVE <br />ant <br />lti <br />Nt <br />I <br />i <br />ifi <br />f <br />b <br />r <br />l <br />f <br /> gn <br />c <br />pena <br />I am swum that there am s <br />es <br />or m <br />m <br />dng <br />s <br />re <br />n <br />ormation, <br /> <br />PRIIITED <br />TYPED <br />OR <br />Including the possibility of line and Imprisonment for knowing folatlons. <br />I <br />OFFICER OR AUTHORIZED AGENT <br />CODE NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Rolorenc• ill offachmunfa hors) <br />PPFC P EVENT YS CLATMEn IF CLAIM APPQnvFn ?3*,' !-lOCD <br />This is a 4-part form. PAGE OF <br />EPA Form 3320-1 (Rev 3/99) Previous editions maybe used