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I PERMITTEE NAME/ADDRESS tlnriude Farifftr Natne/L -ation if DiJferenfi <br />I! NAME <br />` ADDRESS A HCR I ZON MINE <br />BU 6-22S <br />-A CO 81424 <br />FACILITY <br />H nR ; z ci f.t m tr.,r <br />LOCATION CO 81424 <br />.4".UE, '11-4E MANAGER <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMB No. 2040-0004 <br />M N T R <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br /> OF <br />TYPE <br /> EX ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT REi,03Fc T - <br /> REQUIREMENT DA I L Y Pi X. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT T - - - <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT _ <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT 0,C) A <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/TITLE PRINCIPAL EXECUTIVE OFFICER I crrury under wnalty of Iaw that this doctutn•m and all alluchmenLS were <br />n• <br />ared under m <br />di <br />ction or su <br />d <br />w <br />i <br />i <br />h TELEPHONE DATE <br /> p <br />p <br />y <br />tt <br />perv <br />n accor <br />ance w <br />on <br />t <br />a systrm designed <br /> to -&-u" lhut qualir" pe-r nel properly gather and rs aluute the information - - <br />_ suhmitted. Based on my inquiry of the person or perms who manage the system. <br />_ or Ihoss perm directly resprmsible for gathering the information. the information <br /> submitted is, to the hest of my knowledge and heber, true. at urule. and complete. <br /> I am aware that therr am %igniricani Iwnalties for submitting false information SIGNATURE OF PRINCIPAL EXECUTIVE <br />- <br />TYPED OR PRINTED . <br />Including the possibility of rmr and impristatment ror knowing .iolations. OFFICER OR AUTHORIZED AGENT AREA <br />CODENUMBER <br />YEAR <br />MO <br />DAY <br />AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used. 00234 •` .nik-4§44-pan-fornl.