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PERMITTEE NAMEIADDRESSpm"F«+hryN..?Le spo ,up(06,.w) <br />NAME <br />ADDRESS <br />13ciA :754 <br />i1IA CO 81 <br />FACILITY R NO. ? MINE <br />LOCATIUN ;EF{5E' Lac 81 <br />;KIEL E. DEAR, PRESIDENT <br />NATIONAL POLLUTANT OISCHAROE ELIMINATION SYSTEM //NPDESI Form Approved <br />DISCHARGE MONITORING REPORT WMRJ OMB No. 204x0004 <br />PERMIT NUMBER asCHAAOE NUMBER j - F I IVAL. GU <br />MONITORING PERIOD NUFF TO N VK UrNN1O0rv RIVER <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br /> <br />EX p1EOUENCY <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT T ieii k p, ?. } 9, O <br /> REQUIREMENT M i N MAX I I?KjM <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ?t$c#iliF# #Ie#### iEti IFS t ;.. - <br /> REQUIREMENT '- <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT F? E RE:;'OR7 3i#IE#: ?ilEallF?iif ick#'?dEt' r .',. <br /> REQUIREMENT ', .ILY <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ##aEs=# ?E 3F### <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAMEfnTLE PRINCIPAL EXECUTIVE OFFICER t ct""y ° n pen' iy ° 9w that thk do rnrnt and all atrachments wrre <br />TELEPHONE <br />DATE <br />Prepared undemy dletton or uptrHSlon <br />In acco"fann wllh . system dalgr.d <br />to assure that qualified personnel properly gather and evaluate the Information <br />submitted. stated on my Inquiry of the person or prrsom who manage the system, . <br />" <br />or rhose persons directly r"potdble ear gathering the Information, the information <br />submitted 6. to the bet of my knowledge and better, trot. aec ralr, and comPklr. <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />I am ..are that there are slgnlticanl penalties for submittin <br />rain lnforwottlon <br />TYPED OR PRINTED g <br />, <br />Inrkding the pemlbittty of flne and lmtprtsonment for knowing aolatl ? OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference a# attachments hare) <br />. (:] 'rrl,.tT _- CC--r'.fi x(11.1 T•tr , TS„Ti '1•r ItiS?lrr r, 3-f1n <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used TINS IS a 4-pall form. PAGE OF