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PERMITTEE NAME/ADDRESS p.d.& F eWryNsr/Leraoi" (fD(Owwv) <br />NAME <br />ADDRESS <br />BOA 2 154 <br />Ji41A co $i4; <br />FACILITY R NO. 3 11-1. 1 NE <br />LOCATION IERSET CID 814" <br />.+NIFL E LtEAR PRESIDENT <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT IDMR) <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 />i tea. <br />F - FINAL GUI <br />MINE DRAINAGE TO N FK GUNNISON <br />NOTE: Reed Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. UENCY <br />FREQ SAMPLE <br /> OF <br /> EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT . ?. r _,- <br /> PERMIT 1E## I o. fi ?7 , t ._ , . . <br /> REQUIREMENT ?! j T r• .. MAXIMUM <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT E r c. _ 4; <br /> REQUIREMENT ??i;?: ?1 :` _ i,• P <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT r r . x+r . <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT i_jly <br /> REQUIREMENT O£I <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br />REPORT <br /> <br /> REQUIREMENT F, i. L 'r" I <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT :- <br /> REQUIREMENT i"?A <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />1 cent) under penally o la. that N6 dornrnenl and eH aitwhrn nu wort <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER <br />TELEPHONE <br />DATE <br />Prepared under my dirsctlon or sul t"Won In accordance with ¦ system dteafgned <br />to aflare 111¦1 qu.Hnad pe,,nel properly gather and eealuale the Into nallon <br />ssbmiUed. Beard on my Inquiry of Unt person or persons who manage Ills spleen. <br />or those persons directly responsible for lathe ling the InformaUOn, the Infornnllon - t _ _ - <br />submllted h, to the bee" of my knowledge and b~. 'rue. accurate. and complete. <br />10. aware that there art significant pmaltta for rubmltting rain Inforntadoo <br />SIGNATURE OF PRINCIPAL EXECUTIVE - <br />TYPED OR PRINTED . <br />Including the possibility of fine and Impr?sonrnent for knowing v olsUorla OFFICER OR AUTHORIZED AGENT CAKA ODE NUMBER YEAR MO DAY <br />COMMEN I .7 ANV CArLAtte%I tort yr r.re r el- I rung Inwrw <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used <br />urrrw"rx "Wrw/ <br />CAGE IS HIGHEST MONTHLY AVERAGE DURING PERIOD REPORTEE <br />This is a 4-pan form.