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PERMITTEE NAMEIADDFtESS pwd.r F-46q.Aloer?Lorortoo ((D( wwd) <br />NAME <br />ADDRESS <br />BOX 187 <br />CO 8162E <br />FACILITY PPER MINE <br />LOCATION I G -0 B162 E <br />/mmmn (_ nit Rn T q. PRF'q /(2M <br />NATION AI POLLUTANT DISCHARGE ELIMINATION SYSTEM //NPOESI <br />DISCHARGE MONITORING REPORT /DMRI <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO pAY YEAR MO DAY <br />FROM , . TO <br />Form Approved <br />OMB No 2040-0004 <br />MINOR <br />(SUBR JC ) <br />F - FINAL MOFAT <br />GSCHG TO E. MIDDLE FLUME GULCH <br />NOTE: Read Inetructione before completing this form. <br /> <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br /> <br />EX FREQUENCY <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE Ir <br /> MEASUREMENT <br /> PERMIT ##tl##rF trot i b. st##sf'r,% ° ', 'EEKL Ii'dSZT <br /> REQUIREMENT M I IN IMUM NA'x IMUM <br /> SAMPLE i ; I I <br /> MEASUREMENT <br /> * <br />' <br /> PERMIT a # (! !t#3i # ? 3?ie # ##31 ±r J _, '70 }I•?(, ?- , F"' <br />,;:: <br />,i REQUIREMENT 30A A LY M <br />_ SAMPLE / - I <br />- <br />` <br /> MEASUREMENT - - <br />1 PERMIT r :r?:i ?! #if##?°# ;'PTIONAL REPORT NCE/ GRAB <br /> REQUIREMENT Q INS AVG DAILY MX ,-:.- MONT <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT 3000 6000 l?iCE/ Rr;r <br />V ; REQUIREMENT 3(.iLA r tl''y DAILY. MX r,4 T <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT x.. rK-. xst LO <br />ST MAX <br />I <br /> N <br />0 SAMPLE <br />T S-' <br />-,?'MEt. MEASUREMEN <br /> <br />ti PERMIT RE <br />.., r•I ETA <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT F-P RT REPORT <br />REQUIREMENT - -.: A AVG 1:1<? 1 LY MX <br />NAME/TITLE PRINCIPAL EXECVTNE OFFICER ' n 'h under penalty o ¦w that this domrrumt and all uuchmenta were _ TELEPHONE <br />pr pard under my dlrrrtlon w WIN on in necoedonce with ra system designed DATE <br />to sror that auoMfled personnel Properly gather mul eeduole the ]"Formation <br />submitted. Bred on my 1"OrT of the person or Persons who manage the rrrtenl4 6 <br />J? <br />LL <br />- <br />?•? <br />. <br />' - ar those Persons dl rwilr rssporralble for gotheOng Our Intormallosl, the Inform Woa <br />subrrdlted Is, to the bet or my knowledge and belief, true, accurate. and compMe. <br />SIGNATURE OF PRM1CWAL EXECUTIVE - <br />. - . ' ' <br /> I am aware that there are significant penaltle for eubmllting False Information. AREA <br />TYPED OR PRINTED <br />Including the possibility of floe sad Imprbomment for knowing violations. <br />OFFICER OR AUTHORIZED AGENT <br />CODE NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS•IReforence eM attachments hors/ <br />'='._E SOLIDS LIMIT APPLIED FOR 1=IOYR, c4HP PRR•rTP F'•.'ENT- <br />_ MON I TOR I N,:? <br />_ ,_ "? I?tBP? N6 <br />EPA Form 3320-1 (Rev 3199) Previous editions may be used. - Zil!¢ IS a 4 ®TRT, PAGE OF