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PERMITTEE NAME/ADDRESS tlncludr F'arility ,\'trrarlLruatu,n if f)iff r m, <br />NAME _ - _ _ _ -iDU <br />ADDRESS -JN 1111 NE <br />LA c <br />FACILITY HORIZON M I NE- <br />LOCATION I A <br />DICE WADE <br />CO 614 <br />r- NAGER <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPDES) <br />DISCHARGE MONITORING REPORT (D R) <br />I <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />M I NOR OMs No. 2040-0004 <br />(SUBR MH) <br />F - FINAL PIN <br />Std&M I NE DR14G TO TUTTLE DRAW <br />NOTE: Read instructions before comaletinq this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREOUENCY SAMPLE <br /> OF <br />TYPE <br /> EX ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT - <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT i` ins t > fi x s F:3-77 <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT 1?- .?` 1k. *- t..p r C. a : r - • r. _ .t -7,777 <br /> REQUIREMENT tr, ". J=Lt <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 /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I certif) under penaltm of low that this document and all mtachments were <br />prepared under ml dlrretion „r .uper,won in accordable with u sY,a rt designed TELEPHONE DATE <br />tu w-re that qualified per amnel properly gather and evaluate the information <br />submitted. Baud an nt) inquin nt the person or persons who manage the system. <br />i" \ <br />or tbase persons directi) responsible for gathering the information, the information " <br />%ubmiued is. to we best of my knowledge and he1kL true, anurate, and compictr. 7 <br />1 am aware that there are significant penalties for submitting false information SIGNATURE OF PRINCIPAL EXECUTIVE -- <br />. <br />TYPED OR PRINT including the paF ibility or rine and imprisunnw•nt for knowing virdutiom. OFFICER OR AUTHORIZED AGENT AREA <br />NUMBER <br />YEAR <br />MO <br />DAY <br />a.vrnmc_rr,... .•srw a_nr ?r.,.rs ..v,. v. e?a?. rrva.rsrrvra.a Ireererene.e au auaa.rnnerrW seer e! <br />LIM <br />C, T10 <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used. niS N d4-p:m form.