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PERMI'ME NAME/ADDRESS (Ym6&FeedtyN.WLxat,ew(/D(Qwwwq RECEIVED NATIONAL POLLUTANT DISCHARGE EUMINATION SYSTEM INPDESI <br />NAME DISCHARGE MONITORING REPORT (OMR) <br />ADDRESS <br />NOV ' 1 4 2008 <br />bUX 483 PERMIT NUMBER ascHARDENUMeER <br />hJ I A Division, of F2eciamationa MONITORING PERIOD <br />FACILITY I E NO. 2 MI! Mining and Safety YEAR MO DAY YEAR O D Y <br />LOCATION N I A FROM TO <br />LL I AM A. BE <br />Form Approved. <br />OMB No 2040-0004 <br />MINOR <br />(SUBR MH) <br />F - FINAL D <br />5R;'r? :':?= WTR 70 DEER TPA!!.. DTCH <br />ISCHARGE <br />NOTE: Read Instructitms before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br /> <br />EX FREGUENCY <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT b. N7" _ <br />_i_ REQUIREMENT MINIMUM MAXI MUM <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT # TV # +?# tr;r# ?D i J . . <br /> REQUIREMENT 30DA A`"IG DA I LY N- MONTH <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT t A 13 <br /> REQUIREMENT 30DA AVG DAILY 1U. MONTH <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT 30DA AVG DAILY )'IX MU!, i'H <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT f r. f 'r"• >. .. ii## i t hi <br />NT' J REQUIREMENT = s> IM-'5T MAX is>L=^!T <br /> SAMPLE <br />I RE-?, PL. MEASUREMENT <br />0 1 PERMIT ;..; <br />;!:NT GROG- '-/ : REQUIREMENT ODA AVG DAILY MX <br /> SAMPLE <br />.l.! MEASUREMENT <br /> <br /> <br />REPO I <br />PERMIT <br />REQUIREMENT I NST MAY <br /> <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER ' ferwy " n penalty ° low that thh document and an altachmente were TELEPHONE DATE <br />prepared -d.r my direction w fuprr felon in accord. nn with a system desstned <br />I° inure that auadn.d PerUM-1 Popertt ether and...wate the Inrorreatloe <br />wbmltl.d. aaawd on my I"utr7 of the prrson w perwm who manate the y tem, <br />or those persona dlrecdt responsible for gathering the InrormetImk the Inrornrtlon <br />submitted K to the best of m7 lnowlydte end belief. true. o"unle, and complete- , <br />SIGNATURE OF PRINCWAL EXECUTIVE <br />th <br />t th <br />l <br />Nlk <br />nt <br />ltl <br />f <br />ild <br />I <br />1 <br />b <br />r <br />t <br />r <br />d <br /> <br />TYPED OR PRINTED am aware <br />t <br />pma <br />a <br />ere arw s <br />a <br />es <br />or su <br />m <br />ng <br />a <br />er <br />n <br />orm <br />on. <br />Inchrding the ponlbidtr of nee and Imprtwnment for kmaring elolatlons <br />OFFICER OR AUTHORIZED AGENT AREA <br />CODE NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS M.f.renCI 0 atrachments hero/ <br />HP PRECIP EVENT iS CLAIMED. TF CLATM APPROVED BY WOCD, <br />MEASUREMENTS A. 3, PG F P P i'C)• <br />F'G 4 -e T' SAMPLING INETNL _ I IONS-I. C. <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used 7 S;faS 8 4-past form. PAGE -'OF