Laserfiche WebLink
PERMITTEE NAME/ADDRESS(GririF?rWryN??Lerri°wl/DlQirwrr) <br />NAME <br />ADDRESS ~ NL. c__ LANE <br />BOX 483 <br />IA CO 81428 <br />FACILITY E NO. 2 MINE <br />LOCATION 'IA CO 81428 <br />_LIAM A. BEAR JR., MINE MGR <br />Form Approved. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NVPDESI OMB No. 2040-0004 <br />DISCHARGE MONITORING REPORT (D R) _ <br />PERMIT NUMBER DISCHARGE NUMBER - FINAL DEL i r <br />MONITORING PERIOD -7F TO DEER TRAIL DITCH <br />YE &R M DAY I Y MO D &Y <br />- <br />FROM TO - <br />NOTE: Reed kwtructions before comclatina this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREOV NCY SAMPLE <br /> <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX ANALYSIS TYPE <br /> SAMPLE <br />- MEASUREMENT <br />-' PERMIT S :-.; a##it _ ##### REPORI OPTIONAL <br />SEW i.i REQUIREMENT SODA A4G MX 7D AV NON I H <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT r 177T_=_ 7 <br />;_Uchd' REQUIREMENT 30DA MX 7D AV MONTH <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - 1777777 • L 1-14 J <br />I tj <br /> REQUIREMENT M I N I MUM MAX I MUM . <br /> SAMPLE <br />dF)Frj MEASUREMENT <br /> <br /> PERMIT # 1 I <br /> REQUIREMENT 30DA :.. I-1 ,X 7b <br /> SAMPLE <br />M <br />U <br />L .,_.,-... EAS <br />REMENT <br />O 1 < PERMIT . 45 r i <br />r1f <br /> <br />REQUIREMENT <br />AVG <br />MX 7D AV <br />i' <br />Pi;i•'l:_; . <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - , <br />J? •! i sROS REQUIREMENT INST MAX 131=1v 1 <br /> SAMPLE <br />? TF •1' 11c.l'i i MEASUREMENT <br />- <br /> PERMIT - x Lin UT-1 <br /> REQUIREMENT "i SDA ; I LY MX <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER ' Certify under vena ly ° low that this documrnt and all etlwhmeMs were <br />prepared under my direction orwrper.ilon In wrordonce with a:stemdesigned <br />TELEPHONE <br />DATE <br /> to aqua That qualified personnel Properly gather and evaluate the InIb m ation <br />b <br />it <br />d <br />B <br />I <br /> su <br />m <br />te <br />. <br />awd on my <br />"utry of the person or penom who manatie the system. <br /> or'hote penom directly responsible roc gathering the rnro lloa, the Intm-mgri u, <br /> subrnlited ht, to the beat or my knawladga and beW, ime, accunie, and cornph:le. <br />, <br /> I arcs aware that then ser signifkaat Penalties for mbmltdng War Inforrrrtim. SIGNATURE OF PRINCIPAL EXECUTIVE - <br />TYPED OR PRINTED Ineludint the porbiliy or llne and Impr%onmem for knowing iMatiora OFFICER OR A VTHORIZED AGENT A A NVMEIEq <br />YEAR <br />MO <br />DAY <br /> _ CODE <br />LL ummtaV I S Al'Ild Cnra.,+..n r rvrs ... r.... ....? r rvrw <br />rarncw arrr w ar&rif wnij nsral <br />'TRUCTIONS - I. C. 10, PG. 10. <br />EPA Form 3320.1 (Rev 3,'99) Previous editions may be used 333/CUFMS.?344-pad form.