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PERMITTEE NAME/ADDRESS tiicluleFaritio- Name/LxmuonifDitenm) <br />t I r <br />NAME ,( COMPANY. <br />ADDRESS !`iEW r_L?-. Pl.i f4E <br />22 WEST FIRST STREET <br />TRINIDAD Co <br />FACIUTY 14EW ELK MINE <br />LOCATION 1 'JESTON C O <br />t?.:ittt r•ntf=ravel ? <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) Form Approved. <br />OMB No. 2040-0004 <br />DISCHARGE MONITORING REPORT (DMR) n ( 1 <br />L:.r (_.. <br />PERMIT NUMBER DISCHARGE NUMBER - FINAL LAMAS <br />MONiTORINGPERiOD RUNOFF POND 4!PURGATOIRE RIVER <br />y ; <br />YEAR MO DAY YEAR MO DAY <br />FROM Li TO X <br />NOTE: Read Instructions before completing 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 /> SAMPLE <br /> MEASUREMENT <br /> PERMIT n # f.. :: sr U [ .. .. _.. Y _. . . <br />`vALi "c REQUIREMENT it+;( Imi, i? <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT =: i ### a - > 'r ##4t# # ::> i .'G <br />FLUENJ 7'r'0SS VAL.U: REQUIREMENT ,jVi)r" I i=1 <br />_ r " 3? . F SAMPLE i <br /> MEASUREMENT <br /> PERMIT f . <br />71 <br /> <br /> <br /> <br /> <br />n / <br /> <br />a is ii ?t <br /> <br /> <br />_ <br />ONC <br />Fl_JEN i :RCJSS VAUli: REQUIREMENT <br />z.t7fd, - SAMPLE yL <br /> MEASUREMENT - t <br /> PERMIT ?i4 ;i••'sF tiF #-'.f#-## - / :f?-.'.r ; l,l. _! s>tHli <br />rF • C3FOSS V'".i REQUIREMENT Y? .? .?I DA 1-',r i'i;( i1(:lry'r?- <br />ii Gi SAMPLE ? .i : . . <br /> MEASUREMENT <br />_ PERMIT ?4t-1 t'i'1tR=• „ x tyF <br />10 <br /> <br />Ur ! <br /> <br />r, <br />II=aJ REQUIREMENT It-!5T MAX T <br />1 i. SAMPLE s 1 a -. r v # i* # fi# er <br />rY 1„ - MEASUREMENT <br />= 1 PERMIT R%F'T.DR 'f## #it ter?( ! tF <br />i_UENT t-t• i I REQUIREMENT Iii= <br /> SAMPLE f wit • .? <br />I ! AL MEASUREMENT <br /> PERMIT 'rte `t'?# F2F."".: ' 1 # a ;tom## '?iE?k?t ?F Jr'tit 7> ## - t` `? J <br /> REQUIREMENT I N,-- i _ <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of lase that this document and all ana,hmertts %ere TELEPHONE DATE <br /> <br /> <br />l ;; - r <br />h r • <br />^ C <br />i C prepared under my direction or supen isom m accordance with a syaem designed <br />to assure that qualified personnel properly gather and cvalu.rte the mtorinadon <br />. <br />. <br />- <br />v <br />• submitted. Based on my inquiry of the person or persons who manage the system. <br /> or those persons dtreetly re,ponsihic for gathering the information. the information <br />G C G? submtncd is, to the best of my knowledge and belie(, true, accurate. sad complete. <br />f <br />b <br />L <br />f SIGNATURE OF PRINCIPAL EXEC IVE <br /> or su <br />1 am aware that there are significant pettalnes <br />mitting fa <br />x in <br />ormation. <br />l <br />i <br />h <br />i <br />li <br />fi <br />f <br />L <br />l OFFICER OR AUTHORIZED AG NT AR A <br />NUMBER <br />YEAR <br />MO <br />DAY <br />TYPED OR PRINTED e poss <br />ty of <br />ne mat rmprurnmcm <br />or <br />nou mg vto <br />awms. <br />inc <br />ud <br />ng t <br />bi CODE <br />COMMENTS AND EXPLANAIIUN Ur ANY viuLA1 was (rrererence an arracnments nere) <br />T 3D REPORTED. OIL & GREASE - SFF I P I D. F 19 'rCzS'- 'It' <br />_ - i_ TMI'V _ TED FOR <br />_ .1 - <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. This is a 4-pan f6mi. PAGE OF