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PERMITTEE NAME/ADDRESS, Include F"ifirr Nameffocation if Differeno <br />NAME `0RALU. L1. <br />ADDRESS <br />HOX ?.: <br />?A v© S: <br />FACILITY HOR I Z I? N MINE <br />LOCATION LA CO 8 <br />LANCE WADE, MINE MANAGEF <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 />Form Approved. <br />OMB No. 2040-0004 <br />MINOR <br />(SUBR MH) <br />F - FINAL MNrR5 <br />5R&MINE TRNG TRIG TO TUTTLE DR <br />NOTE: Read instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br /> <br />EX OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE r r <br /> MEASUREMENTi <br /> PERMIT r, t _ <br /> REQUIREMENT AVG DAILY IrIX MONTr <br /> SAMPLE <br /> MEASUREMENTI <br /> PERMIT REF L' <br /> REQUIREMENT 3CIDA AVG DAILY f•I <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT t jri r _I <br /> REQUIREMENT t:,DA AVG 'iX <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ;1l <br /> SAMPLE <br />-, „ MEASUREMENT <br /> PERMIT 3F PEPE <br />r - <br /> REQUIREMENT DA 1 <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT } r ?. <br /> REQUIREMENT DAILY N" <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT :r:, r:` ' v i? • ; Y '.. I°i0i: <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER I crrt,b under penalq orlaw that thisdo umem and.11.11arhmem were <br />re <br />ared under net direction or w <br />eni4on to accurdanre with u %%%tem da i <br />ned TELEPHONE DATE <br />_ p <br />p <br />p <br />g <br />to as,u- that Qualified prnonnel properly gather and e%aluute the information -- l <br />- submitted. Based on m% inyuin of the person or persons who manage the system, - <br /> or those persons direc iv respofl ible for gathering the information, the information <br />' <br />_ <br />--- - suhmHt d is• to the hest of ms km,wiedge and MIier. true. aecuratr. and complete. <br />I am aware that them are si <br />enalties fur suhmittin <br />nificant <br />falu information <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />TYPED OR PFHNTED g <br />p <br />g <br />, <br />insirding the possibility or rim and imprisonment for knowing yiubtions OFFICER OR AUTHORIZED AGENT <br />1 <br />CODE AREA NUMBER <br />YEAR <br />MO <br />DAY <br />COMMtN I S ANU tAF'LANA I IUN UI- ANT VIULA I IUNS (fYererence an arracnmenrs nere) <br />EPA Form 3320-1 (Rev 3/99) Previous editions may be used. 000133 / CIT?tf.1r :' 4=1ki£t`fOI att.