Laserfiche WebLink
PERMITTEE NAME/ADDRESS ilnctadir FaciAr.0ameil"ation if Di ferentp <br />NAME <br />ADDRESS <br />EOX ;'570 <br />EPA CO 616;39 <br />FACILITY I•_CA MINE COMPLEX <br />LOCATION EN co E4 2 639 <br />%f;RO, RECLi"IMATION 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 Apped. <br />OMB No K0-0004 <br />F - FINAL <br />DSCHG TO TRIB/FI5H GREEN <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NQ, FREQUENCY SAMPLE <br /> <br />EX OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT l:. • ,, ?;` . `' - <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 /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER I r,rtir. under lamalo of lass that IN%documrnt and all attachmems arm <br />Prepared under my direction or supervision in accordance with a systrm designed TELEPHONE DATE <br /> to assure that qualirted personnrl properly gather and es aluate the information <br /> suhmitted. Based on mi inquiry of the person or persons who manage the y.ctem, <br /> or those prnoos directh responsible for gathering the information. The information i <br /> suhmitted b, to the bea ,d M knuwlydge and hellcf. true. o uratr. and complete. <br />I <br /> I am aware that there are significant penalties for suhmitting false inrormation SIGNATUR OF PRINCIPAL EXECUTIVE - <br />' <br />TYPED OR PRINTED . <br />inhaling the possih0hyor fine and imprisonment for km,wing si,datioo.. OFFICE OR AUTHORIZED AGENT A <br /> <br />REA NUMBER <br />CODE <br /> <br />YEAR <br /> <br />MO <br /> <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />':a <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. 00094,' This! ib a 4-{part'-form.