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PERMITTEENAMUADDRESS(/-0"for&ryVo--VL trfon((D(fw.wr) NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (AfPDE$) <br />NAME DISCHARGE MONITORING REPORT IDMR) <br />ADDRESS <br />bQx 48_ PERMIT NUMBER DISCHARGE NUMBER <br />,NIA <br />FACILITY i I E Nn . i ;L MONITORING PERIOD <br />LOCATION NIA CO 81 t .: YEAR MO DAY YEAR MO DAY <br />FROM TO <br />LLIAM A. BEAR JR., MINE M1"'_ <br />MINOR <br />(SUER MH) <br />F - FINAL <br />CHRONIC WET TES <br />Form Approved. <br />OMB No. 2040-0004 <br />E 1A <br />NOTE: Reed Instlvctione before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br /> <br /> <br />EX <br />NCr <br />FREOUE <br />OF <br />SAMPLE <br />TYPE <br /> NALrSts <br />A <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ###1ti4: tt ca k:x> ieiF3t#s P### .F±'_:: - <br /> REQUIREMENT S INGSAMP <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 />NAME/TiTL E PRINCIPAL EXECUTIVE OFFICER I cent' r u r p•na ly ° law that this document and It attachmenH wert <br />TELEPHONE <br />i <br />i <br />h <br />GATE <br />prepared under my direct <br />on or superel/wl In accordance w <br />t <br />• system designed <br />to tare chat qu.IIn d personnA properly gather and evoualt the Inrn tlon <br />submllled. goad on my Inquiry of the Person w prr who managt IM system, .. <br />or Ihoa[ ptrsom directly resPornibk for gatheAng the Informauon, the Infwmati m <br />submllled K to tht beat of my knowledge and Dtgtf, lrm, accurate. and comPMe. 1 <br />i <br />ffk <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />I <br />l _ <br />- ` <br /> am aware that then are s <br />gn <br />at <br />pcnaltko for submitting fate infor Gow. AREA <br />TYPED OR PRINTED Inctuding the poatblgly or fine and Imprisonment for knowing efwatiom OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS IRs/erence 0 a"Schments here) <br />Farr-7 ni=SSUL TS OF LETHALITV ?rRI`:'S ?S "' F FFCT". r R(?)r)i-? ANT. <br />r.T I S7I CALL-! <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used T}11$ JS a 4-Pa FL f(grIT1. PAGE OF