Laserfiche WebLink
PERMIT-TEE NAMEIADDRESS tincietdr Fxilifv A'alpr/lncnriun if tmf erep <br />NAME <br />ADDRESS <br />BOX 628 <br />LA CO 81424 <br />FACILITY HORIZON MINE <br />LOCATION i 4 CC 61424 <br />AN("F WATIF. MIMF MAiUAt,FR <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPDES) <br />DISCHARGE MONITORING REPORT (D R) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />FROM YEAR MO DAY TO YEAR MO DAY <br />Form Approved. <br />OMB No. 2040.0004 <br />FINAL IMINTHS <br />INF_ DRNG TO TUTTLE DRAW <br />NOTE: Read Instructions before comoletinQ this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION N0. FREQUENCY SAMPLE <br /> <br />EX OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br />P MEASUREMENT <br /> PERMIT tEPORl' <br /> REQUIREMENT ',A Ak:O i7AI. <br /> SAMPLE - <br /> MEASUREMENT <br /> PERMIT REPORT REPORT <br /> REQUIREMENT ;:ODf- AVG DAILY MX <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT C-)-, I- P,ET: - .. _, <br /> REQUIREMENT A V G , Ft i ' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REPORT <br /> REQUIREMENT <br />DHlt. I I%s <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAMETITLE PRINCIPAL EXECUTIVE OFFICER I certify under penult) of law that this document and all attachmems arm <br />e <br />d <br />ti <br />d <br />di <br />e <br />i <br />i <br />d <br />i <br />h <br />d <br />i TELEPHONE DATE <br /> pr <br />pare <br />un <br />er my <br />tut or suprrs <br />m <br />% <br />on <br />n accor <br />ance w <br />a svslem <br />es <br />gned <br />t <br /> to assure that yualirterl por.onnd properly gather and esaluale the information <br />------- ubmilled. Based on my inyuin of the perwn or pawns who manage the +ystem. <br /> or thaw perw,ns dirauy rosplatsibk fur galbering the information, the inrurmatiun <br />- <br />- It, nitt,d is. to the two of my kn.wlydge and Wief, true. accurate, and complete <br />I am aware that there are signirnanl penalties fur submitting falx information <br />SIGNATURE OF PRINCIPAL EXECUTIVE I - _ - - <br /> , <br />i <br />l <br />di <br />h <br />ili <br />n OFFICER OR AUTHORIZED AGENT AREA <br />TYPED OR PRINTED nc <br />u <br />ng t <br />e r-ib <br />tr of <br />nr and impriwmnxnl for knowing siolations. NUMBER <br />CODE YEAR MO DAY <br />M11W cnrt_ lvv I.vln yr -1.1 -t_MI'- s Incrm crrotr en 01I0tA1IIICIIIJ acre/ <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used. 00225 / C fA-, Q" 4-0aWf( m.