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PERMIME NAME)ADDRESS(?-&&FwoiyX-. tL«.etnnllD(fwvw) <br />NAME <br />ADDRESS <br />BOX 187 <br />IG CO 816E <br />FACILITY ?-,RPER MINE <br />LOCATION ',.1 G CO 8162E <br />vmnnln r-% nil GRnTC:. Gp9=4-_/AM <br />NATIONAL POLLUTANT OISCHAftOE EUMINATION SYSTEM //NPOFS) <br />DISCHARGE MONITORING REPORT IDMR) <br />PERMIT NUMBER DISCHARGE NUW <br />MONITORING PERIOD <br />YEAR MO.. DAY Y AA MO DAY <br />FROM TO <br />Form Approved <br />OMB No 2040-0004 <br />MINOR <br />(SUER JC) <br />F - FINAL MOFAT <br />POND TO FAR EAST BUZZARD GULCH <br />NOTE: Reed instructions bof we completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. ?EON?' <br />OF SAMPLE <br /> EX S TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSI <br /> SAMPLE <br />MEASUREMENT <br /> L 79S <br /> PERMIT 111 P <br />I I Ilium MAX I MUM . <br />!JciV 7 t'R REQUIREMENT S <br />L.,?, I SAMPLE <br />5'7 <br />S7 <br />FENDED MEASUREMENT <br />30 1 C ( PERMIT <br />i?F:7 Vr" REQUIREMENT :3;JliA t-t`U DAILY" NX. MONTI <br /> SAMPLE <br />/ <br /> MEASUREMENT L I <br />0 C' PERMIT _ Fr <br />GROSS l REQUIREMENT 30DA AVG DAILY MX MONTF <br />,_ SAMPLE ' <br />S FE) MEASUREMENT <br /> <br /> <br />1 0 <br /> <br />PERMIT <br /> <br />h <br />:• it <br />b ?4 1`1 All <br /> <br />LUENT GRG . <br />REQUIREMENT iODA A'.';= DAILY Mx MONTH <br /> SAMPLE <br /> MEASUREMENT ;?t ?i^' <br />A2 1 Q O PERMIT <br />_-UENT '?Rl7SS Vi-'•! REQUIREMENT TN5T MAX AT <br /> <br />J TREATMENT P: SAMPLE <br />MEASUREMENT <br />- <br />F <br />0 1 0 O PERMIT r <br />r-LUENT GROSS REQUIREMENT .ODA -AILY MX <br /> SAMPLE <br />r- r- <br />310 L_VL1 MEASUREMENT <br />PERMIT <.. <br />REQUIREMENT - 30DA AVG DAILY MX <br />NAMEfnTLE PRINCIPAL EXECUTIVE OFFICER t under ga diirs° taw that thh ,a and alt with yff were TELEPHONE <br />Prepared coder m my y dctton or sup-Mon Mon llon In In r,teerdanrt rllh a e yatem designed <br />' to tare that qualified personnel properly gather and evaluate the informs Uon i DATE <br />7 submitted. Based on my Inquiry of the person or Persons who manage the Sweat, <br />- or those persons directly responsible for gathering the Informatkm the Information <br />1 <br />wled <br />i <br />t <br />d <br />! <br />k <br />d b <br />tl <br />f <br />M <br />- <br />my <br />no <br />ge an <br />e <br />e <br />, <br />rw, atevn <br />e. an <br />comP <br />e. <br />0 <br />j .• <br />_ r /,i ? submitted Ys, to the bn <br />EXECUTIVE <br />IIA <br />if I am swan that there are dpdnuM Penalties for Remitting false Information, SIGNATURE OF ?RINC <br />L BER A <br />Y O <br />TYPED OR PRINTED Inhaling the possibility of flaw and Imprisonment for knowing rblatfom OFFICER OR AUTHORIZED AGENT CODE NUM E <br />R M DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference off erreenmenra nere/ <br />_ --ABLE SOLIDS LIMIT APPLIED FOR <=10YR,24HR PRECIP EVENT- <br />c 1.1"!,J I TOR I N'EPA Form 3320-1 (Rev. 3/99) Previous editions may be used 0033 ? 7E &S-P?:14 ITp, PAGE OF <br />:- d/`-