Laserfiche WebLink
PERMITTEE NAMEIADDRESS Qoclw& rfNryNw?[«r,o? l/D?G.wnj <br />NAME <br />ADDRESS <br />NIA CO 81428 <br />FACILITY 1 E 1,40. 2 MINE <br />LOCATION d I A CO 8142-18 <br />..LIAM A BEAR JR., MINE MGR <br />NATIONAL POLLUTANT OISCHARGE ELIMINATION SYSTEM fINPDESI <br />DISCHARGE MONITORING REPORT (DMRI <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY Y AR MO DAY <br />FROM TO - <br />Form Approved <br />OMB No. 2040-0004 <br />MINOR <br />( SUBP. MH ) <br />F - FINAL DELTI <br />CHRONIC WET TESTING FOR 006A <br />NOTE: Read kletructione before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FFIGUENCY SAMPLE <br /> OF <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX ANALYSIS TYPE <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT iF##sF ., :a?E## 3 REPORT <br />###it x st <br />k###.tt <br />; ; ; _.. <br />f = :'?! REQUIREMENT SINGSAMP r <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 /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br /> REQUIREMENT <br />NAMEnME PRINCIPAL EXECUTIVE OFFICER t rentty ° er Penalty o law that thH drxorrw t and d1 atf-hnwub were <br /> <br />prepared under my dlrxlMn ar tuPer+Non In accordance with • syviern designed <br />TELEPHONE <br />DATE <br /> to tswre that qualllfed personnel Properly gather and evaluate the Information <br />mbmltted <br />Based on m <br />r th <br />in <br />ui , <br /> . <br />y <br />q <br />ry o <br />e Person or persons who manage the system, <br />th <br />d <br />i <br />rI <br /> or <br />ose persons <br />imrty r pons <br />blr for gathering the Inluerrutlon, the Information <br />i rubmllted b, to the best of my knowledge and beW. true. ecrunte. and rompkte. . <br /> I am swam that there ¦m tigvinrant penalths for asbmltdng fair Informatbn, SIGNATURE OF PRINCWAL EXECUTWE <br />TYpED OR PRINTED Imitoding the Possibility or one and Imprisonment f« knowing elolat>om OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Re/srence dl attachments here) <br /> <br />G <br />EPA Form 3320-1 (Rev 3199) Premus editions may be used TWS_r5, a 4-part form. PAGE OF