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Form APProved. <br />FERMITTEE NAME/ADDRESS (7-.6* FwarryiVsaa?Lecuiae (/D(awrw) NATIONAL POLLUTANT OISCHAIIOE ELIMINATION SYSTEM (/NPOES) OMB No. 2040411104 <br />NAME DISCHARGE MONITORING REPORT /DMRI <br />ADDRESS _; UD k t <br />1 <br />,_ . ISUX PERMIT NUMBER DISCHARGE NUMBER ; - F • I NAL GUNI S <br />rIERSET -_u 8114;-1 -1 ,:--DIM EN'i POND TO SANBORN CREED <br />FACILITY ^1HORN CRK ELK Cf:K F'17 NFS MONITORING PERIOD <br />_ YEAR MO DAY YEAR MO DAY <br />x <br />LOCATION MERSET C: J i' 3 FROM TO <br />;''.MES T. COOPER, EXEC V i NOTE: Read kntructione before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br /> <br />EX OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />-1. SAMPLE <br /> MEASUREMENT <br /> PERMIT il?F r REPORT 1 ##it# :: ##ic iE 3?### TNCE? VISUAL <br />i GFi I!': REQUIREMENT I NST MAX MOW,: i <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 /> PERMIT <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />e r pen.1) o (law that this dotomrnt and all anachrnrnts wen TELEPHONE <br />NAME/ fnE PRINCIPAL EXECUTIVE OFFICER DATE <br />prepared order my direction or wper.!>fon In etcord.nr. with . f)slem designed <br />- _? that qualified personnel P?H7 gather end eealu.le the information <br />i T ed. Based nn my Inquiry of the penal or persons who manage the s <br />stem <br />7 <br />y <br />, <br />thaw persons dImctlf respo edbk for gatherin <br />the Information <br />the inform <br />ti <br />g <br />, <br />a <br />on <br />b the bet of my know ed <br />mb"Altod <br />Ia <br />e and b <br />I <br />tl <br />f <br />e <br />nte <br />d <br />ka <br />- <br />, <br />g <br />, en <br />e <br />e <br />, <br />rve, at <br />v <br />comp <br />t. .n that then an ffgnmr.nl <br />m.tttef nor srrbmtatn <br />f.he nror.nal°n <br />SIONATVRE OF PRINCIPAL EXECUTIVE <br />TYPED OR PRINTED p <br />g <br />, <br />I° Iudirn the podblsry• or nrw end Impri,onmeni for knowing .tol.u° K OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Roforence aN attachments here) <br />f : Ti _EAPLF ?1)i.Tf?S LMT APP' ?cr, rr ?t'R, ?:?+F1R PF"rF'' <br />v: i'. _=I HR EVEN f _.EE I. A f _. <br />Im. <br />PAGE <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. This iS a 4-Part form. OF