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PERMITTEE NAME)ADDRESS (tnsin4 Fadhy va.wL«wfa" rrDWirwr) NATIONAL POLLUTANT OISCHMOE ELIMINATION SYSTEM (NPOESI <br />NAME DISCHARGE MONITORING REPORT (DMR) <br />ADDRESS <br />BOX PERMIT NUMBER DISCHARGE NUMBER <br />IG <br />PER M i tvtFACILITY _ MONITORING PERIOD <br />LOCATION c0 816-- YEAR MO_ _R 4Y YE AR I MO. D Y <br />-' <br />,MOND G. DU BOFS, FROM TO <br />PRESiGM <br />Form Approved. <br />OMB No. 2040.0004 <br />MINOR <br />(SUER JC) <br />F - FINAL MOFAT <br />POND TO WEST 1YEATT GULCH <br />NOTE: Read kntrucdone b*fW* compMtk+p this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, SAMPLE <br /> EX M TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT 5 h _ <br />r ' 06 REQUIREMENT MINIMUM MA X Z MUM <br />_., SAMPLE r. <br /> MEASUREMENT <br /> PERMIT - . <br />X21 :` REQUIREMENT 3013) AVG DAILY MX "ii ('JTF <br /> SAMPLE <br /> <br /> MEASUREMENT <br />0 113_.: ? G PERMIT 1 1114 <br />K- Li.;E1-41 GR(-!`_; REQUIREMENT ` ? IPdST f'1AX GENT <br />- l 4i; SAMPLE <br />:. <br />TREATMEIV ` L r" MEASUREMENT <br /> <br />0 PERMIT r -. L t <br /> <br />. <br />C] <br />(? R REQUIREMENT - C?'A 'Y.` ; A Y M X `. <br /> SAMPLE :. <br />JL'?L MEASUREMENT I <br />'5 1. O PERMIT ,: r f <br />i •: REQUIREMENT 30VA AVM' DAILY MX <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT REPOR; i r :,• a=: -. , <br /> REQUIREMENT WST, X ;- VTF <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAMEfrrrLE PRINCIPAL EXECUTIVE OFFICER ' "^" y ° r w"a'y I." that this eocvment and `° "tacnmenu ""` TELEPHONE DATE <br />prepared antler my direction or mper.Non In accordancr with • system designed <br />to <br />th <br />t <br />u <br />NMd <br />nnel <br />r <br />th <br />th <br />I <br />r <br />l <br />d <br />l <br />t <br />f <br />l <br />_ <br />atom" <br />a <br />q <br />a <br />pe <br />so <br />p <br />oper <br />y ga <br />er an <br />eva <br />ua <br />e <br />e <br />n <br />ornu <br />bn <br />? - <br />rtbmined. Bard on my Inquiry tithe persoo or person who manage the system. <br />, <br />or those persons directly rsepordble for gathering the Infoirmati n. the Informrt{on ?-'- <br />sub <br />th <br />bnt of m <br />knowled <br />itt <br />d Is <br />t <br />t <br />d b <br />W <br />t <br />' / <br />l <br />. ?. <br />m <br />e <br />, <br />o <br />e <br />y <br />ge an <br />e <br />rue, aavra <br />. <br />e• and comp <br />ete. : <br />,. - • - <br />I am - that thrrv are ,Ig„ Inrant prnal"es for submttttn <br />SIONAnME Of PRINCIPAL EXECUTIVE <br />retie Inm n atlon <br />TYPED PRINTED g <br />, <br />Including the poadbiuty or MM . Rt impnxnmrnt roc knowing .Id.u ns OFFICER OR AUTHORIZED AGENT CAREA ODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reforencir sat attachments here) <br />ABLE SOLIDS LIMIT APPLIED FOR =1OYR, 141-IR PRF,-TP <br />?JORING ±! r! !: <br />^ITk?LY?,sj4'..01+" i;-ii+at= nL- J- ;Lr, i:,pnFAj jir, <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used. This-is a+pan;fOrtn. PAGE OF <br />t'