Laserfiche WebLink
PERMITTEE NAME/ADDRESSrlgrit&FerOiyNnoWt? at/am(/D(fty-1) <br />NAME <br />ADDRESS i ?! 3II: <br />13OX 483 <br />PAONIA co 814 <br />FACILITY -.,) I E N0. 3 MINE <br />LOCATION NIA CO 614Z <br />t 1 T Aad A nr_wn l6 PATNIC MflC <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM fNPDES/ Form Approved. <br />DISCHARGE MONITORING REPORT WWI ^dOR ONIS No 2040.0004 <br />;I•JBR MH) x <br />PERMIT NUMBER DISCHARGE NLWRER - FINAL DELTA <br />MONITORING PERIOD DEER TRL DTC OR UNMD TRIO <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />NOTE: Read Irtstructlorts before complstlny this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br /> <br />EX FREOUENCY <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE s <br /> MEASUREMENT <br /> PERMIT r ??1 .? sf?l # # s . .. C - C, EEKLY PI'S I Tt <br />:;S VALI- REQUIREMENT MI?Vl. 1lAXIMUM <br /> SAMPLE } z .- .. ; <br /> <br />. MEASUREMENT <br />'p <br />1 C PERMIT #### ! # t ;. ?t3tz `!CE/ F ^_t <br />ENT GN'. REQUIREMENT MONTH <br />J. DGa I 5E i SAMPLE <br /> MEASUREMENT <br />C PERMIT f<? ? ;, # # a # I(?F JI REPORT 145PORT E `, <br />RC :. REQUIREMENT SODA AVG DAILY MX ' .. MGPITH <br /> SAMPLE , z... -, <br />t H5 i ,. MEASUREMENT <br />F 1 PERMIT ###### #;t #-f 000 6000 NC'.: ;R •,n, <br />_t)ENT f3RD'- REOUIREMENT y 30DA AVG DAILY !':' MONTH <br />F SAMPLE mot. ,- <br /> MEASUREMENT <br />G C? PERMIT - #.t - ## 3f a s- 3f# ?41 1 F- _: <br />i i ?hc05 ':'N? .,t REQUIREMENT MAX GENT <br />IN CONDIJ T ?1P SAMPLE <br />TREATMENT PLAN. MEASUREMENT <br />(l 7 PERMIT REPORT i s-_; ,:• # z?* t it 3 # -., r <br />'- _RrJ?:_ REQUIREMENT 30 LA A ILY 1" <br />t( ?l_ SAMPLE <br /> MEASUREMENT <br />PERMIT r't -URI <br />REQUIREMENT ;.,1RTR AV(; DR fR Mr. <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER ' cer1i11 " P- 1] ° Iaw that thif document and .II a1lKhmenU wen <br />pnp.red utder T) di-II.- or wper.Nom In accordance rltA ¦ )Item dnlgncd TELEPHONE <br />DATE <br />10 amun that graMM1rd perwnnO proprft] Lalhef and erahralr the Information <br />abm111rd. Saed on me Inquiry o (the person of persona who man?Re the system, <br />of Ihow peraotn dlrwIlY Mpondb* for galheArK the Information, the Information <br />wbmltted b, to the beat of my luwwledge and belle!, (I. accurate. and complrw j' <br />rdn <br />SIGNATURE OF ?RINC"IAL EXECVTfVE <br />h <br />1 <br />l <br />m <br />Rk <br />for <br />brWri <br />f <br />t <br />I <br />tb <br />l <br />f <br />- <br />-' <br />TYPED PRINTED en art z <br />g <br />caa <br />p <br />a <br />, <br />w <br />nt <br />a <br />e <br />n <br />orma <br />1 and aw.m tha <br />t <br />n, <br />Inchdlnt the pealDlMl) of nne and lmprtaonrwenl for knowlng ridatlorti OfFFCER OR A VTNORIZED AGENT CAREA ODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION of ANT VFVLA I IVN5 rtforarsnee an srrwcnments nerd <br />cgrrT? ^' >-?+? T?; Ct.ATI`ED IF' C! e^!M: APPROVET? RY 1,40CD, <br />EPA Form 3320-1 (Rev 3199) Previous edtbons may be used. This is a 4-part form. PAGE OF