Laserfiche WebLink
NAME <br />ADDRESS J ; I NE <br />LOX 459 <br />-i- ENCE = R 81226 <br />FACILITY R MINE <br />LOCATION DEN CO 604BO <br />_nnc b rt::":nC''tht n'Chl Rtfl0 <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOES) Form Approved. <br />DISCHARGE MONITORING REPORT (DMR) OMB No. 20404=4 <br />,_?r! JC ) <br />PERMIT NUMBER DISCHARGE NUMBER F T NAL JCK.SN <br />TAN RIVER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. OF FREQUENCY SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE . <br /> MEASUREMENT <br /> PERMIT 4x U. 5 r < t .17CE C-! <br /> <br />= i- 'Ji_i' i Gftii575 VAL_'v: <br />REQUIREMENT <br /> <br />-r- <br />N I (•.i I - ` <br /> <br />' <br /> <br />_ i=: : D ! SAMPLE <br /> MEASUREMENT <br /> PERMIT ;?;r ryt3t ;r# .s FIT f'OfR T I Q. 5 W ; CEf RAG <br />i=FrLUEadi GRQSS Vr^. -iji REQUIREMENT ?t.n H`?„ i ti'F <br /> SAMPLE <br /> MEASUREMENT <br />? PERMIT ; Q fiA t# .'i r,i R A, I; <br />E <br />-t 127 I JAL_•_: REQUIREMENT <br />1r' , IN <br />SAMPLE <br />a c ;, <br />T HRU T REATHEi•JT PLAN C MEASUREMENT <br />.? <br />0 L <br />? PERMIT 9t•fYt#?- it- -? d-# r .r?? i# ? ?: .. .:.. r\1 COF4G" <br />, <br />j <br />= r i- 1 laRt_ c7 c_j VA' i REQUIREMENT I NX } <br /> SAMPLE <br />_ ; ; raL MEASUREMENT <br /> PERMIT R3i:F7 t ?h: F]T tj=.1 iisi+f;r#'t i+?<rKV?t #s! f#<+ ti <br />rF. _ REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I tertdj under penalty of law that this drwument and all attachments were <br />TELEPHONE <br />DATE <br /> prepared under mp direction or super, ision in accordance with s system designlYl <br />t,, _ <br />:j iC1 acrd A. ?''Mun son to assure that qualified personnel properly gather and evaluate the information <br />h <br />th <br />- <br />t <br />f <br />h <br />/ l <br /> e person or peru ns w <br />o manage <br />e sN <br />s <br />em. <br />submitted. Based on my mymry o <br />t <br />the information <br />ns directly responsible for gathering the information <br />those <br />rs -'t='`^- - <br />' <br />Vice Presi!? Et1 t . <br />or <br />pe <br />o <br />k <br />m l <br />l <br />ef <br />true <br />a <br />c <br />rat <br />nd <br />om <br />let <br />i <br />th <br />t <br />f <br />d <br />d b <br />b <br />d <br />b Q?O ?2?-?338 mF 1{? 0' <br /> ni <br />. <br />. <br />c <br />u <br />e. a <br />p <br />e. <br />tte <br />is. to <br />es <br />o <br />my <br />e <br />ge an <br />e <br />i <br />c <br />su <br />m <br />e <br />b <br />l <br />i <br />l <br />f <br />f <br />fo <br />i SIGNATURE OF PRINCIPAL EXECUTIVE <br /> mitting <br />se in <br />rmat <br />on. <br />can: rena <br />ues <br />or su <br />a <br />I am aware that there are sicmt <br />ti <br />f <br />tu <br />k <br />i <br />d OFFICER OR AUTHORIZED AGENT AREA <br />NUMBER <br />YEAR <br />MO <br />DAY <br />TYPED OR PRINTED rn <br />now <br />oaa. <br />ine :ma nnpm aunem <br />ng su <br />a <br />including the piaahdiq of CODE <br />I.VMrgr.pI I.7 AIYU r-AYI.FIIgmiIVIV Vr m"I V1VLM11V17J Irl Crclvirr w a.. arraa.r.rrrcrraa r.c. c/ <br />:t_?IP EVENT SUP,.?T=CT Tn BURDEN OF PRCrDF RFni TRF""FNI-? TAI <br />,'.. - THE i t <br />EPA Form 3320-1 Rev. 3/99 Previous eddiors may be used. .)03 6, 1 & PAGE OF <br />' / i ???, 19?• ,