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FERMITTEE NAME/AODRESS (7-6 rF?rNryNr,¦rrL«rrow I/D(QG.wr) <br />NAME l <br />ADDRESS <br />bLJX <br />CO 81524 <br />FACILITY .-;LANS CANYON MINE <br />LOCATION i`,A CO 81524 <br />.;'ALTER WHITLEDGE, MINE MGR. - <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEAA //NPOESI <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEA MO DAY <br />FROM TO - <br />Form Approved <br />OMB No 2040-0004 <br />MINOR <br />(SUBR DW) <br />F - FINAL GRFLD <br />c---Et;I POND DSCHRG TO E SALT CR. <br />NOTE: Read Inetrucdone before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREOUENCY SAMPLE <br /> <br />EX OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />- SAMPLE <br /> MEASUREMENT <br /> PERMIT lErt .. 1 -PCJRT <br /> REQUIREMENT NST MAX <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />1 "May under pena ty 0 law that W2 document and all attwhments were <br />TELEPHONE <br />NAME/T171E PRINCIPAL EXECUTIVE OFFICER <br />DATE <br />prepared under mr dlreellon w wpenMon In arioMance with a systern designed <br />to eawre that qu N[f" personnef pro" y gather and e+duate the Wnrimat1cm / <br />? > ` <br />d <br />i <br />f <br />. <br />. submitted. Base <br />no my inqu <br />ry o <br />Ue person w Persons who manage IIM system, r L I1/< <br />or thou pemme, dineny responsible for gathering the Infarsrutlew, the Information <br />the b <br />" <br />k <br />wl <br />d <br />b <br />l <br />d <br />r <br />d <br />g <br />t <br />e <br />o <br />my <br />no <br />e <br />ge an <br />. ,mss su <br />m <br />[te <br />K to <br />be <br />e <br />, [roe. ser-mte, and complete. <br />I am aware that there are sl <br />rrlkant <br />enalties for wbmilun <br />W. Wn-n- <br />SIGNATURE OF P0104CWAL EXECUTIVE <br />, Q y <br />L) <br />G <br />TYPED OR PRINTED g <br />p <br />g <br />. <br />IMuding the Potability of fine and Imprisonment few knowing .W.w- OFFICER OR A VTHORtZED AGENT A A <br />CAE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION Vr ANT VIVLA I IVNS frfererence an ermcnrrfrnrs nere] <br />AIILF Tpa LTMITf7 APPLIED FOR =IOYR, 24HR RFCIP EVENT; <br />! v i E---i«---?-1•e e r ' i:--•^---+?t y4d E?LJFZ f-i?le? -: ? r? ? i <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. Jc L? % This is a 4 part -form. PAGE : OF