Laserfiche WebLink
PERMITTEE NAME;ADDRESS rlrtcfrrJr Fx-rlrry NawyL,..r;an Pfl)i ferevul <br />NAME <br />ADDRESS N i NE <br />(!fY RGAD 63 <br />r 78 81641 <br />FACILITY <br />LOCATION ELY Cl 81641 <br />- 1 J I-illLART). MINA. MANAGER <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />F <br />Form Approved. <br />OMB No. 2040-0004 <br /> <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUAUTY OR CONCENTRATION NO. FREQUENCY OF SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT r- <br />- REQUIREMENT t <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT f ' <br />-7:1 t..11-1 . ,; -;-3 =N, REQUIREMENT <br />.' u <br />` SAMPLE <br />C,`?'.` i?,-,; • ..!. = _, =-l F ? MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />( i SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br />( fl !_ REr"VERASU7 MEASUREMENT <br />' Q PERMIT <br /> <br />REQUIREMENT r- r <br />r: •. ? ., ?. <br /> SAMPLE <br />- F ;- -- MEASUREMENT <br /> PERMIT f t .a t y <br />4T REQUIREMENT 1. <br /> SAMPLE <br /> <br />_ MEASUREMENT <br /> PERMIT Q TF. <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I cenity under penalty of law that this document and all anachmcmts were TELEPHONE DATE <br /> <br />Slimy ?[?? y/Sf? prepared under my direction or supenlston to accordance with a syuem deigned <br />to assure that qualified personnel properly gather and evaluate the informaiot <br />Y _ <br /> suhmawd. Bated on my inquiry of the person or pcrsonc who manage the sy col. <br />i or those persons direcdy responsible for gathering the inforntaGon, the information -- - <br />_ to the hest of m <br />knowledge and bchcf <br />truc <br />tcruratc <br />submitted is <br />and complete i 7 <br /> , <br />.. <br />. <br />} <br />, <br />. <br />r <br />: <br />cn <br />::d: <br />h <br />t th <br />irc <br />ti <br />am <br />lt <br />s f <br />1, <br />fotm <br />t.m <br />I SIGNATURE OF PRINCIPAL EXECUTIVE C:• <br /> <br />TYPED O RINTED am swan <br />e <br />e . <br />. <br />w <br />pena <br />or - <br />wi <br />:e <br />e m <br />e <br />. <br />n <br />c <br />ie <br />including the •..,h ::, ,• ,nc and impri>onmcnt ,•, r.•: legion.. OFFICER OR AUTHORIZED AGENT AREA <br />CODE NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />EPA Form 3320-1 (Rev. 3/99) Previous edilions may be used. l0Q`71 • TIt1S Js.a pDit, folm.