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PERMITTEE NAMEiADDRESS thos de Facili. Nnmr'Lrnation IjDi/ferentr <br />NAME <br />F.RGYr INL <br />ADDRESS ; -t,0 ,. UNC 'r I ON MINE <br />--7 JACKSBORO HIGHWAY <br />HITA FALLS TX 76301 <br />FACIUTY a Ori 1)Us\C T I iJN NINE. <br />LOCATION ANGO CID 8I `.'Qi <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) Form Approved. <br />DISCHARGE MONITORING REPORT (DMR) OMB No. 20440004 <br />i :?ULSiY ??L <br />PERMIT NUMBER DISCHARGE NUMBER F FINAL LPLTA <br />MONITORING PERIOD c`sFDI POS.;-,r?1301\ ;l YN <br />- <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />NOTE: Read Instructions before comoletinq this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY <br />OF SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />?1' H SAMPLE <br /> MEASUREMENT <br />00 ?'.. G 7 PERMIT r t L <br />S <br />r <br />F w I r' r <br />7 AL' <br />E l G .055 AL. i1; REQUIREMENT 11 UM :,NTf <br />:?I]L : U`: 7 . , ..=t SAMPLE Lc: <br />SUSPEPd_ :- MEASUREMENT <br />C'0530 PERMIT .., ;? t k-a tt 5 ?L <br />?FFLI)I-'1dT C;RL? ?? `JF?Llti REQUIREMENT 'tt :,1' <br />SOL_ i.1 TL P SAMPLE : <br /> MEASUREMENT <br />005;4 C. PERMIT .T .. S ? <br />` 1Ji iRAIj <br /> <br />E S ?i=:; <br />EFFLUENIT .. r,Rp. REQUIREMENT <br />•; <br />DAI: ;?ia <br />t <br />1". <br />CJ I L_ SAMPLE <br /> MEASUREMENT <br /> PERMIT if## # t-. .: # 3i=i, # L l :rd „RftG <br />EFFL iv iS tJr;i REQUIREMENT N9T MIAX <br />LfJ(.)r• J .. 1tJU :. SAMPLE <br />AI`.i <br />THRU TF `-NT PL MEASUREMENT <br />_ PERMIT FORT REPORT '.??'?##>f r#d68t:r?t ?s?tat### (,n <br />EFr-, ti, REQUIREMENT 3 AVG :`A Y 1'1X <br />j <br /> SAMPLE it t i! >r <br />D i MEASUREMENT <br />7C' .?5 PERMIT ,tEPORT PEFORT <br /> <br /> <br />FFFLUEN" 4L <br /> <br />REQUIREMENT ?:FDA Ave <br /> <br />`D <br /> <br /> <br />X <br />; <br />.. . <br />i L A1'ii SAMPLE ! . : . k c t > <br />V I SUAL MEASUREMENT <br /> PERMIT <br />- R:. a iP t a I #de# r -# ^ t - - i :. {A' <br /> REQUIREMEN <br />NAMEMTLE PRINCIPAL EXECUTIYE•9PPtCfR I certify under penalty of law that this document and all attachments acre TELEPHONE DATE <br /> <br />M 1 prepared under my dirccnon ,•r supcn mion to accordance with a system destgncd <br />l <br />f <br />l <br />h <br />d <br />h <br />A <br /> uatc t <br />orntauon <br />to assure that qualified personnel proper <br />y gat <br />er an <br />c. a <br />e m <br />? <br />v ICE PVvx:?A!- ?-TJPT suhntittcd. Based on my mquun of the person or persons vitro manage the system. ^ <br />? <br />V <br /> oq the intormntion <br />or thow per%wu directly responsible for gathering the - <br />1_. <br />NC rue <br />accu <br />knowled <br />and belief <br />ac orate <br />and complete <br />th <br />b <br />st of <br />title <br />b <br />iu <br />d <br />t ? O ?U d I J <br />I . <br />, <br />. <br />e <br />my <br />ge <br />. <br />, <br />su <br />m <br />c <br />ts, <br />o <br />e <br />f <br />f <br />l <br />t ATURE OF PAIN (PAL EXECUTIVE <br /> un. <br />or submitting <br />a <br />se m <br />I writ awar e that there arc significant penalties <br />i <br />i <br />o <br />k <br />l OFFICER OR AUTHORIZED AGENT AREA NUMBER YEAR MO DAY <br />TYPED OR PRINTED ion-S <br />onmmt f <br />r <br />nnwmg sto <br />aurn s. <br />including the possibility of f <br />ne and tmpr CODE <br />COMMENTS AND EXPLANATION OF ANY VIOLA IIUNS (Hererence an arracnmenis nerejI <br />PRECIP EVENT SUBJECT TO.,IBURDEN OF PROOF REQUIREMENTS IN <br />:. _ ED TO THE DIVISION WITHIN 48 HOURS. <br />t1040T.taisrkYPari.?fprm. I <br />EPA Forth 33241 (Rev. 3,199) Previous editions may be used. riac,t