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PERMITTEE NAME/ADDRESS(I-"F-INOYMn.a/Locariaeel/D(f-wa) <br />NAME <br />ADDRESS <w,- <br />BOX 53S <br />:ERSET CO 81434 <br />FACILITY 3ORN CRK & ELK CRK MINES <br />LOCATION 5RSET - - - co 81434 <br />NATIONAL POLLUTANT DISCHARGE EUMINATION SY9TEM /INPDESI <br />DISCHARGE MONITORING REPORT /DAR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />corm App, vvou. <br />OMB No 2040-0004 <br />MINOR <br />(SUBR MH) <br />F -- FINAL i <br />SEDIMENT POND TO HUBBARD CREEI <br />NOTE: Read kntruetione before complotinp this form. <br />Uiv . <br /> F <br />NO <br />FNEOUENCY <br />SAMPLE <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION . <br />EX DE <br />9 S <br />TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALY <br /> SAMPLE <br /> MEASUREMENT <br /> i <br /> PERMIT It i1 #### iFit#### ?. 5 ###### 9. G NS I T <br /> REQUIREMENT MINIMUM MAX I MEJM MONTH <br /> .- <br /> SAMPLE ?r :i sr <br />;- <br />- MEASUREMENT <br />i ` <br /> PERMIT ###### at##IF## it'F11### ?? 70 NC E? ?AS <br /> REQUIREMENT !3 V ' Y tT3NTtt <br />I I=rtl{LE SAMPLE - -' <br /> MEASUREMENT <br /> 'I 1 <br />" <br /> PERMIT +'t #'f ### ::? s ## REPORT REPORT NCE/ 2 <br />F: a, <br /> REQUIREMENT "-',QDA AYC, DAILY MX MONTH <br /> SAMPLE <br /> MEASUREMENT <br /> ' <br /> PERMIT t( ii , # > a t ;r# 3SOC) 703, 0, NC I= / is 4. b <br /> REQUIREMENT 20VA Al?G DA IL i' NX ? F <br /> SAMPLE - <br /> MEASUREMENT <br /> t; ;, <br />-? <br /> <br />- PERMIT <br />##?t?r?.?? <br />?•?#•sf <br />.._ .. <br />= .. 10 ON , <br />. <br /> REQUIREMENT LNST MAX <br /> SAMPLE <br /> MEASUREMENT <br /> <br />O PERMIT REPO)? DEPORT #### ##### * # x## NCE/ <br />R OS? REQUIREMENT 3DDA A. L: A I LY MX I+TI?NT <br />i TA L- SAMPLE <br /> MEASUREMENT <br />r Y <br />; <br />I• <br />R P <br />PERMIT Eat##; st3 se 3t#at zrjr?t#?. , R R . <br />I <br />L <br />REQUIREMENT :30DA m4., u'; L,r-ALY MY <br />NAME/TNTLE PRINCIPAL EXECUTIVE OFFICER i renity under penalty o (law that this docomtni and call¦uachmenu were TELEPHONE <br />prepared under my direction or supervision In acsordanrt with a system designed DATE <br />to enure that quanned personnel Property gather and evaluate the Infornutbn _ ?.. <br />- - - submitted. Based on my Inquiry of the person or persons who manage the system. -- i{ <br />. <br />or those persons directly responsible for ptAtrfag the infornut{an, the Inforrrrtlen 6, <br />submitted Is, to the best of my knowledge and tseIW, true. s"vralr, and con kte. <br />EXECUTIVE <br />N <br />? <br /> I am ..are that there art signinmat pensitles for sub-Itting false Information, SIGNATURE OF PRI <br />CI <br />L <br />E <br />ENT hkwR YEAR MO DAY <br />TYPED OR PRINTED Including the podbnlty of nor and Imprisonment fw knowing Ootstlor¢ OFFICER OR AUTHORIZ <br />D AG ODE <br />COMMENTS AND EXPLANATION OF ANY VIOLA I IUNS fHerwrenc• an arra.cnmmra nwrq <br />FABLE SOLIDS LMT APPLIED FOR C=l0YR, 24HR PRECIP EVENT; <br />This is a •N-part forni PAGE OF <br />EPA Form 3320-1 (Rev 3/99) Previous editions may be used