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PEAWME NAME)ADDRESS(InrcYfrfaeilly)Vrta/L ,wienl/DWwww) <br />NAME t <br />ADDRESS <br />LOX 53S <br />=RSET CO 814 <br />FACILITY i30RN CRK & ELK CRK MINES <br />LOCATION ,RSET CO 814 <br />.tcc r r•nnoco cvcr to P <br />NATIONAL POLLUTANT DISCHAROE ELIMINATION SYSTEM (/NPOESI <br />DISCHARGE MONITORING REPORT (OMR) <br />PERMIT NUMBER DISCHAROE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY P R MO DAY <br />FROM TO _ <br />Form Approved. <br />OMB No 2040-0004 <br />MINOR <br />(SUBR MH) <br />F - FINAL GUI <br />SEDIMENT POND TO HUBBARD CREEK <br />NOTE: Reed Instructions before completing this fwm. <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 afar# afaf ate#### 0 : 6. 5 :_ NCE/ INN,', <br />r? l- GR G ?: - REQUIREMENT Min=t X i MUM M NT <br />TOTAL. SAMPLE <br /> MEASUREMENT <br /> <br />0 PERMIT aF?F## :: rrt##;1zt ?t#yt#sFsi _ ?O DICE/ _ eA <br />(rRi7c;`.• REQUIREMENT A Y i fiClNT <br />TT [ I SAMPLE - <br /> MEASUREMENT <br />5 1 0 PERMIT S#### ##'t### ### REPORT REPORT i'.Ir.i/ ,R4=;-3 <br />UENT G-R0S`: REQUIREMENT 30DA AVG GAILY MX i'• iiL}NT <br />r, Tr;T e% SAMPLE <br />(An MEASUREMENT <br /> <br />c PERMIT #3E i : >tx t r d# iF# 3?C3V 7000 Nr, <br /> REQUIREMENT ;?0DA AV() DAri-.Y MX <br />Ar, SAMPLE - <br /> MEASUREMENT <br />-, <br />_ 4- PERMIT r .., . i Q (7NT 1 : R c' 2 <br /> REQUIREMENT rNST MAX - tdT <br />1r ' SAMPLE 3 , <br /> MEASUREMENT <br /> PERMIT REOOR ' REPORT i rataF# :. -a k#?x <br /> REQUIREMENT 30 DA F• ILY MX <br />T[' SAMPLE <br /> MEASUREMENT <br />PERMIT ?liar#x 7 ##et 't ?rar #x. REPORT REPGRT <br />REQUIREMENT JODA A. vL ", 1LY NIX <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER i cerltly ° r Pena ty o law that Uti document and all ¦llachm is were TELEPHONE <br />ervttim In <br />with a s <br />stem desi <br />ned <br />d <br />n <br />m <br />di <br />ti <br />r <br />rdan <br />l DATE <br />y <br />g <br />er <br />y <br />rec <br />on o <br />sup <br />acco <br />ce <br />prepare <br />a <br />g <br />- <br />?- to assert that quaNfled prrtonnei proper() jlalAer and eederalt the Information <br />mbmllted. Based on my inquiry cr the ptrton or persona who manors the system, <br />{ <br />i <br />j or those perm dimity responsible for ptherint the Infermation• the Information G <br />'!) / <br />mrbmitled Is, to the bed or my knowledge and bd W. true, acrurate. and complete. <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br /> I am .wart that them on tl(nitt"m Prnalfles for rbmtlting; fobs Informaeon• AREA <br />TYPED OR PRINTED Includlnt the Possibility of f1m, and Imprisonment fa ?nowing eic4st)ms. / OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference aN attachments here! <br />- <br />-ETT1 t=Ar__F "11-IDS LMT APPLIED FOR -C=10YR, 24HP P RFC?P F"VFp37 <br />; <br />I A <br />- 1, PP 4 -5, <br />C <br />b <br />d <br />1 This is a 4-Part form PAGE Of <br />. <br />99) Previous editions may <br />e use <br />EPA Form 3320-1 (Rev 3 <br />I