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IEAM"'TEE NAMEIADDRESSpft,&&F.rfbyN..?Lerrfoe(/now u) <br />NAME <br />ADDRESS <br />BLIX 483 <br />,:]NIA CC <br />FACILrTY -I I E NO. 2 MINE <br />LOCATION _I N I A cc <br />' LLIAM A. BEAR JR., MIP <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPOESI <br />DISCHARGE MONITORING REPORT ID R) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMB No. 2040-0004 <br />MINOR <br />(SUER MH) <br />F - FINAL <br />DSCGH OF SR TO GUNNISON RIVEF <br />NOTE: Read Irletructlorle before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREOUENCY SAMPLE <br /> OF <br /> EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT . 5 #####'a l3 <br />~ E>=KLY N' <br /> REQUIREMENT MIN [? Et:''i : 1AX IMUM <br /> <br /> SAMPLE - <br /> MEASUREMENT <br /> PERMIT # I+?lf tf# stsr#x L 4####tt _ lC) 1';L; f *?, <br /> REQUIREMENT i..i•1X hiQh(TH <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ##### ##>i #####'r REPORT REPORT <br /> REQUIREMENT 30DA AVG DAILY NIX. MO N <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT ;## ###### #It### 3000 6000 lNCEi •RAB <br /> REQUIREMENT 30DA AVG DAILY MX MONTH <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ; a :: •? s ; . 35 }; #iF# : = 1 '` [ I`1 F' ?, ,_' <br /> REQUIREMENT : <br /> i !dST MAX T <br /> SAMPLE <br />_Al MEd ( MEASUREMENT <br />C PERMIT REPORT REPORT <br /> REQUIREMENT 0DA F; ..AILY MX <br /> <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT PEPORT . <br />REQUIREMENT iRTR =. iTR MAX <br />1'NitY Y eat erne IT o law that thls docn menl and oil allachmenu were <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />TELEPHONE <br />DATE <br />Prepared under my dlrectlon or sups <br />rHtlon In acrordann with • system designed <br />to usure that qualified Personnel property ether and evaluate the Information <br />submitted. Sand on my Inquiry of the Person or persons who manage the system. ' <br />--- <br />or those persero directly responsible for gathering the Information. the Information - <br />submitted Is. so the bet of my knowledge and belief. true. ateurale• and complete. <br />1 am aware that there are sirnlncant p-Itin for submitting fate Informatlon <br />SIGNATURE OF PRINCWAL EXECUTIVE <br /> , <br />TYPED OR PRINTED Includlnt Ilse possibility of floe and Imprisonment for knowing -Wado- OFFICER OR AUTHORIZED AGENT COOS NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Refirenca aN attachments hare) <br />=ire PRECIP EVENT IS CL4Ts'IF-0 IF* ?;TM APPROL'FP- !. <br />MEA?URFMENTS-SEE ?l)RCJEt'.( <br />PAGE OF <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used Tql?S-AS a 4-paf1j f9rtt1.