Laserfiche WebLink
PERMITTEE NAME/ADDRESS flnclade PacilityNamelLoration ifDifferentl <br />NAME <br />ADDRESS <br />II. -f-jk 670 <br />DEN CO 8163 <br />FACILITY CA MINE COMPLEX <br />LOCATION EN CQ 9163 <br />KARR: RECLAMATION MANAGER <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) I <br />PERMIT NUMBER DISCHARGE NUMBER 1 <br />MONITORING PERIOD <br />FROM YEAR MO DAY TO YEAR MO DAY <br />Form Appgpved. i <br />OMB No 2040-0004 <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NQ, <br /> <br />EX FREQUENCY <br />OF SAMPLE <br /> ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br />r I U / <br />rr <br />} <br />MEASUREMENT <br />V <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 /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAMENITLE PRINCIPAL EXECUTIVE OFFICER I ,ertifs under penalty of law that this documrnt and all attachments were <br />Prepared under ms direction or super, won in accordance with o system designed TELEPHONE DATE <br />to assure that qualJed Personnel properfy gather and esaluate the Information <br />submitted. Rased on my inquiry of the Person or persons who manage the sy+tem. r <br />or those penans directlt respmsmle for gathering the Information, the information .. --) <br />submitted is, to the best of my knowledge and beller, true, accurate. and complete. <br />I am aware that there are ,Ignirkant penalties for submitting raise Information <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />. <br />TYPED OR PRINTED including the pcsibility of fine and impriumment for knowing siolations. OF ICER OR AUTHORIZED AGENT AREA NUMBER <br />CODE YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br /> <br />EPA Form 33201 (Rev. 3119) Previous edi ions may be used. 002414 / C Phis i% a 4-0ert form.