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PERMITTEE NAMEIADDRESS pmcirdr foundryNwaarLocwtew(/D( www) <br />NAME <br />ADDRESS Ili r <br />BOX <br />iIA C0 8] <br />FACILITY C NO 2 MINE <br />LOCATION I i I A C G ° I <br />f TAM A REAR .1R MTN I% <br />NATIONAL POLLUTANT OISCHAAGE ELIMINATION SVSTEm (/NPDESI <br />DISCHARGE MONITORING REPORT IDMRI <br />PERMIT NUMBER DISCHAAGE NLOASER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved <br />OMS No 2040.0004 <br />MINOR <br />(SI-IL MH ) <br />F - FINAL G' ?._ Ta <br />SR;DEER TRL DTC OR UNMD TRIF <br />NOTE: Read irietrut:t(orve before compiet" this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, <br /> <br />EX FREQUENCY <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT tr;r ft st # # ;t 0 ELKLY N I"f+•_ <br />L°JT C•i?i,'=: REQUIREMENT MINIP!, MAXIMUM <br />Ti ' . SAMPLE . 4, <br />?D)=T. MEASUREMENT <br /> PERMIT ??# f?I 4 a t,;•It sr_ 70 •'A9 <br />- _'LiV ( REQUIREMENT DAILY i MONTH <br />L .! UL , SAMPLE <br /> MEASUREMENT <br />5 1 0 PERMIT # r# !> # sF't ?r>* # # REPORT <br />REPORT '>;PORT <br />!?i?a( `;ROS' '• `;I-"" REQUIREMENT 3 0 D A AV'_` DAILY MX ;1L?L MOr~I;'H <br />Ti ! f A; SAMPLE <br />?A`. MEASUREMENT <br /> PERMIT is##??#?t #3?### # i.-, -r r!Ou t-000 <br />fvc?E! <br />_. <br />r r !.IJEt' - i REQUIREMENT 3 0 D A F..- !aILY MX MONTH <br />AN, SAMPLE ? --- . <br /> MEASUREMENT <br /> PERMIT >s #At.4 1'. ? i. Q f•1 _ . <br />!:.?J ! Rc ,"L • _ REQUIREMENT ztat?T MI=.X OEN-r <br />T Pd SAMPLE <br /> MEASUREMENT <br /> PERMIT REPOR. REPORT <br />1 NT VA. REQUIREMENT _,0DA E,. :t,.ILY MX _ <br /> SAMPLE ,.. _ <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT = <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I cenr f under pen' 1, ° aw that thb document and all attachments were TELEPHONE <br />a A DATE <br />prepared under my direction or fupre <br />m In accordance with a system delpwd <br />to assure that qualified personnel Pr We y rather and e,Wuale the Infoensatlon <br />sobmllled. eerd on my Inquiry of the person or persoru who manage the system. <br />or Ihose perverts dlrecllr raponsIble for gathering the Inforsrsatlon, the hsformetilen <br />{ <br />submit(ed ls, to the best of my knowledge and belief. live. accurvtr. and connplrle. <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />i <br />i <br />l : ) <br /> I am own- that them are sign <br />ficant pensida for subm <br />tting hbe <br />nfonna(lon. AREA <br />TYPED OR PRINTED Including the poadbnitf of fine and Imprisonment roe knowing rlolmdw OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Reference eat effechrnenfa here/ <br />Tr 'r r•iT IF, (lI ati"`rn TT- "I ATM '\Pi'R0VFT'1 RY k(,)CC,, <br />EPA Form 3320-1 (Rev 3199) Previous editions may be used This is a d-part form PAGE of