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PERMITTEE NAME/ADDRESS (7-6& ForWryMwr1?rL°rulow I/D(& ws) NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOES) <br />NAME DISCHARGE MONITORING REPORT IDMR) <br />ADDRESS <br />GOX PERMIT NUMBER DISCHAAGENUMBER <br />. I A MONITORING PERIOD <br />FACILITY I E NO. _ (`I 11,4h- YEAR MO DAY YEAR MO DAY <br />LOCATION ,'•,{ I A CO $1 4: FROM TO <br />L-LIAM A 13FAR .1R MINE M( <br />Form Approved <br />OMB No 2040-0004 <br />MINOR <br />(SUBR MH) <br />F - FINAL <br />FiSCHG OF SR TO GUNNISON RIVER <br />NOTE: Read In attuctions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br /> <br />EX FREOVENCY <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT it#iFlt ;. ### . 5 i i <br /> REQUIREMENT MINIMUM i?AXIMUM <br />0S. TU? SAMPLE <br />MEASUREMENT <br />11t,.:- r. <br /> PERMIT 70 <br />-t•: REQUIREMENT ;VG Cl z i i pl.; I Tt <br />I <br />P'i tt•; <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT #####i1 ####i(# ##3F'F#3i REPORT REPORT t NCE/ 'RAT; <br /> REQUIREMENT 3U,'--°A AVG DAILY NX MONTH, <br /> SAMPLE t3 <br /> MEASUREMENT <br /> PERMIT I, .? :; 3e ### .' IF####? 'jD^}G 6GUG NEE/ F*HL <br /> REQUIREMENT ,00A AVG DAILY MX MONTH <br /> SAMPLE <br /> MEASUREMENT <br />i 0 PERMIT <br />REMENT <br />R <br />' <br />- EQUI iNST MAX <br />c?V <br />f <br /> SAMPLE <br /> <br />. MEASUREMENT <br />i. C PERMIT F%E.i'; <br />- NT GR' REQUIREMENT <br />.: SAMPLE <br /> MEASUREMENT <br />PERMIT _ ?__ x: ;t. :• .s ati?t sr# r# r ! _, L <br />AEGUIREME14T I i T M+A X ' . <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I ferItt7 under penalty ° law that thh d« nwll and III .n.chment.. rrt <br />TELEPHONE <br />DATE <br />prepared under my dlr llon oruper.hoIn crd.nre wlih s syslem desgned <br />10 asure Thal qualified pereoonet Proprr17 Lather and e•aluste the Inrorterllon <br />mbmltted. Based on m7 Inquiry of the person we persons who manage the s7slrm, , <br />Of than persoru dimity retpon IW for gsthMng the IerormaUou, tM Inrormatlon _ <br />aubmltled b <br />to the best or m <br />kno. <br />* and brIW <br />Irm <br />s <br />r <br />l <br />ktr <br />d <br />y <br />9 <br />. <br />, <br />. <br />a <br />c <br />a <br />r, an <br />comp <br />. <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />dituwt <br />ena111es for submildn <br />robe lnr <br />mats <br />1 own aware that there are sl <br />n <br />TYPED OR PRINTED p <br />P <br />g <br />or <br />o <br />. <br />Including tie poaalblUty of fine sod Imprisonment fw knowing folatiom OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS IRefsrence aM strechmonta heral <br />=HR PRECIP 7VFrl' IS CLAIMED ',P1 ?VFL i_'-' l 1(7 D. <br />MEASUP.Ei•'? SEE 7 F=f" r 77 <br />r' ^r <br />EPA Form 3320-1 (Rev 3/99) Previous editions may be used Thi4 1514 4.-puq EQTm. PAGE OF