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PERMITTEE NAMEIADDRESS (Include Facility Name/Location if Different)
<br />NAME BOWIE- ' -F-SO , t,= r LLC
<br />ADDRESS BU' IJ. J?,10• I MIWFS
<br />P. #I, r, 0x 101x3
<br />P Eli DNI ;T A CO 8 16i 2'_'7
<br />FACILITY MO. 12 MINES
<br />LOCATION
<br />P t#!Ol?1 r tai s0 rY 1314-18
<br />.Ai'T"r WI- nwC.,TI r, r- 'Wt
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPDES)
<br />DISCHARGE MONITORING REPORT (D R)
<br />?p O Oa t;Cfir A
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM Q, O e' () :d TO .t; 01? :30
<br />D1 .-CH TO FAVV,ER D11TCHI
<br />Form Approved.
<br />OMB No. 2040-0004
<br />9B,_Tc=
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<br />NOTE: Read Instructions before completing this form.
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<br />F" ODE 7 "'?+'OSS VA L DI_ REQUIREMENT HON E s
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of law that this document and all attachments were TELEPHONE DATE
<br />.
<br />??jyr 1? f}I(? jl`?
<br />r , 6 prepared under my direction or supervision in accordance with a system designed
<br />to assure that qualified personnel properly gather and evaluate the information i
<br />I submitted. Based on my inquiry of the person or persons who manage the system, • -
<br /> or those persons directly responsible for gathering the information, the information
<br />10
<br />V 1) submitted is, to the best dl' my knowledge and belief, true, accurate, and complete.
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<br />. I aware that there are si
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<br />enalties for submittin
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<br />including the possibility of tine and imprisonment for knowing violations.
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<br />CODE
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<br />? T? _ t"a tt Et.L IDS LwIM!" FOP, 0- YR; 24HP. PREC P EVZWNT SL)3J F'rT U DURDEHNf OF PROOF R:,0U7RV-_-ME'a5 TIN
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<br />EPA Form 3320-1 Rev. 3/99) Previous editions may be used. r ?*d r phi PAGE
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