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PERMffnE NAME/ADDRESS (yneIa*F *8yNanWLocar0onVDIWaranq <br />NAME CENTRAL APPALACHIA MINING, LLC <br />ADDRESS MCCLANE CANYON MINE <br />P. 0. BOX 90 <br />LOMA CO 8152P, <br />FACILITY MCCLANE CANYON MINE: <br />LOCATION LOMA CO 81524 <br />ATTN: WALTER WHITLEDGE, MINE NOR. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR1 <br />CO003Q34 U:02 x <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YE R MO DAY <br />FROM TO .a <br />MINOR <br />(SUER DW ) <br />F - FINAL <br />I HRONIC WET <br />Form Approved. <br />OMB No. 2040-0004 <br />TESTING FOR oo;:)A <br />GR LD <br />## NO DISCHARGE E!I <br />NOTE: Reed Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br /> <br />EX FREQUENCY <br />OF SAMPLE <br /> ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />TO C , SAMPLE #### # ###if ## <br />? ## , # vb##*3 * ( 2G) <br />A <br />P I MEPHALES CHRONIC MEASUREMENT <br />: 1425 S 0 G PERMIT <br />HFtt'sF?! i RI sir <br />i <br />SEE COMMENTS BELOW REOUIAEMENT <br /> SAMPLE <br /> MEASUREMENT ". <br /> ;>PERMIT; <br />_ REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REOUIREMENT> <br />. <br /> SAMPLE {' <br /> MEASUREMENT <br /> ':PERMIT ;', _ <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> iPERMIT _ <br /> EOUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT::.- <br /> AEMENT <br /> SAMPLE <br /> MEASUREMENT <br /> !PERMIT ' <br /> REdUIRfcMENT <br /> <br />NCIPAL EXECUTIVE OFFICER 1 rerldy u er Penalty o ow that th b document and all attachment were <br />TELEPHONE <br />DATE <br />NAME/TITLE PRI prepared under my direction or sup ervMon in accordance with a system designed <br /> to assure that qualified personnel properly gather and evaluate the Information <br />d <br />I <br />i <br />f <br />h - <br /> submitted. Base <br />on my <br />nqu <br />ry o <br />t <br />e person or persons who manage the system, <br />/// or those persons directly respordbk for gathering the Information, the Information t Ya <br /> <br /> <br />a n <br />submitted b, to the best or my knowledge and belief, true, accurate, and complete. <br />I <br />t the <br />i <br />nificant <br />nalti <br />f <br />th <br />b <br />itti <br />b <br />I <br />r <br />f <br />i <br /> <br />SIGNATURE OF PRINCIPAL EXECUTIVE / <br />/0 <br />?Z. <br /> g <br />pe <br />es <br />am aware <br />re are s <br />or su <br />m <br />ng <br />e <br />n <br />a <br />o <br />ormat <br />on, <br />p ED OR PRINTED Including the possiblllty, of fine and Imprisonment for knowing violations. OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />Y <br />COMMENTS AND EXPLANATION OF ANY VIOLAI IONS /Rsferpnce all srcecernsnrs nsr•/ <br />SEE I, A. 3 FOR DETAILS OF TEST PROCEDURE. REPORT LOWEST % EFFLUENT AT WHICH STATISTICALLY SIGNIF RIFF <br />BTWN TEST & CONTROL WAS OBSERVED USING TEST CODE `IS". REPORT IC25 USING TEST CODE atpan, , .IWC=1001. <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. 00352% GT,4-Df?rttl.. PAGE OF <br />d 2