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<br />PERMITTEE NAME/ADDRESS (include Facility Name/location i/Differentl <br />NAME <br />ADDRESS X <br />X <. -} <br />co 8163 <br />FACILITY ?r+ MIF' COMPLEX <br />LOCATION SEN CO $163 <br />T' KARD: RECLAMATION 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 />Form AppfSved. 46 <br />OMB No. 2040-0004 <br />GtiRl.N <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY <br />OF SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT J <br /> PERMIT <br /> REQUIREMENT - <br /> SAMPLE <br /> j <br /> MEASUREMENT - <br /> PERMIT <br /> <br />REQUIREMENT 1 <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT _ t. -7 _ <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - I <br /> <br />REQUIREMENT c 1 '- <br /> SAMPLE <br />1 <br /> MEASUREMENT ?J <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE O / <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER I crrtlfj under penult) of law that this d-ument and an attachmrnts . rre <br />v TELEPHONE DATE <br /> prepared under m% direction or super <br />ision in accordance with a w%lem designed <br /> to aswrr that qualified pernnnrl properly gather and ecvluvte the infurmvdaa 1 <br /> submitted. Ravel on mr inyuin of the person or percents who manage the s?%tem. <br />or th- penimr dirrcd's rrammible for gathering the Information. the Information <br /> submitted is, to the two of m> hnnwledge and belief, true.vcrumic. and cumplew <br /> <br />i SIGNAT E OF PRINCIPAL EXECUTIVE - .J <br />l'. <br /> I am aware that there orr .ignifiicant prnnltirs for whm <br />tling fake information, <br />riohttions <br />-ibilit. A fine and im <br />risonment for An-in <br />di <br />the <br />i <br />l <br />OFFI R OR AUTHORIZED AGENT AREA <br />NUMBER <br />YEAR <br />MO <br />DAY <br />TYPED OR PRINTED p <br />g <br />nc <br />ng <br />p <br />. <br />u D <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. 00263 . Ttusti"s a 4-part=f nii.