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PERMITTEE NAMEMDDRESS (Iweiyf.rYebx..?t«ute?VD(Obwr) <br />NAME <br />ADDRESS <br />i-. O. BOX 187 <br />,"PRIG CO 81621! <br />FACILITY P PER MINE <br />LOCATION I G CO B 162 t <br />YMOND G. DU BOIS, PRES/GM <br />NATIONAL POLLUTANT 04SCHARGI ELIMINATION SYSTEM (NPOESI <br />DISCHARGE MONITORING REPORT IDMR) <br />PERMIT NUMBER DISCHARQI NLOASER <br />MONITORING PERIOD <br />YEAR MO YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMS No. 2040-0004 <br />MINOR <br />(SUBR JC) <br />1= - FINAL MOFAT <br />POND #2 TO EAST PYEATT GULCH <br />NOTE: Reed kntrucdom before Completing thb f0l' <br /> <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREQUENCY <br />OF SAMPLE <br /> EX LYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANA <br /> SAMPLE <br />I I <br /> <br />? <br /> MEASUREMENT <br /> Y <br />. <br /> PERMIT .. , .__ <br />__ . <br />JEN'1 REQUIREMENT MINI^1U1°I MAXIMUM <br /> SAMPLE <br />ENDEL MEASUREMENT <br />?: 1 <br />r <br /> 70 . v, <br />, <br />O 1 G PERMIT K . <br />GROSS V, REQUIREMENT :30DA AVG DAILY MX MONn <br /> SAMPLE <br />/ <br />' <br /> MEASUREMENT - <br /> T r' <br />- L 0 PERMIT 7 A - <br />r- IJENT GRDc REQUIREMENT :_iODA AV6' DAILY MX i. MONTH <br /> SAMPLE <br />(AS FE) MEASUREMENT <br />1 D PERMIT <br /> <br />..UENT ORU. `. <br />REQUIREMENT 20DA AVG DAILY MX <br />L) E .. ,_ SAMPLE l i <br />/ { <br />i <br /> MEASUREMENT <br />s._'•2 1 O O PERMIT r, tr ti x r y. <br />L_UENT GROSS VAL.. REQUIREMENT IPJST MAX GENT <br /> <br />TREATMENT PL A 'i SAMPLE <br />MEASUREMENT <br /> <br />?t <br />1,4 <br />1 0 0 <br />PERMIT :. <br />„ , <br />. ,. ,. <br />l1rNT GRO`- JAL-'.ji REQUIREMENT ?ODA FI':?= DAILY MX <br />_ ..,, SAMPLE <br />SSOLVET'' MEASUREMENT L <br />c r PERMIT . _ 17 <br />' REQUIREMENT - DA AV(, jHILY MX <br />NAMERTTLE PRINCIPAL EXECUTIVE OFFICER I "miry ° r penalty o law that thb document and an attrhnwnts were TELEPHONE <br />p"pamd under my direction or supervisions In accordance with a s"Iem de atrwd DATE <br />to secure that qualified personnel properly gather and evaluate the Information ?. . <br />subrrrtted. eased on my Inquiry of the perwo or Person who menage the system, - V -? - -? <br />_ <br />? w those persons dimcity respondbk for gathering the lnfommitiow• the Inform ttlon <br />. <br />4 <br />j submilted b, to the best of my knewyfte and belief, into. acct file, and aompkle. <br />IN <br />NAL EXECUTIVE <br />P <br /> I am ¦ on that there ere slgdficawt penalties for stnbmiiting Sabo Information, SIGNATURE OF <br />R <br />C A A <br />NUMBER <br />YEAR <br />MO <br />DAY <br />TYPED OR PRINTED Indrding the Podbilitr of fine and Imprisonment rot knowing violations. OFFICER OR AUTHORIZED AGENT CODE <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Reference all attachments hotel <br />L <,; -I_-EA13LF SOLIDS LIMIT APPLIED FOR <:=10YR, 24HR PRECIP EVENT- <br />- I. T l ING <br />P_ 171 <br />?ll"Q4 PAGE <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used. "Pty ?' <br />---------- ----