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PERMITTEE NAME/ADDRESS (Jwti FwOtyNw?L«.Haw I/D(OWw w) <br />NAME ' i <br />ADDRESS <br />J. B (_) X 187 <br />i HAIG CO 81 <br />FACILITY TRAPPER MINE <br />LOCATION A I G CID 81 <br />?AYMOND G. DU BOIS, PRES/GM <br />NATIONAL POLLUTANT DISCHARGE EUMINATION SYSTEM NPOES) <br />DISCHARGE MONITORING REPORT /D R) <br />PERMIT NUMBER DISCHARGE NIIMSER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved <br />OW No. 2040-0004 <br />MINOR <br />(SUBR JC) <br />F - FINAL <br />RUNOFF/MINE WTR TO OAK GULCH <br />MOFAT <br />NOTE: Read ktetructione before complatbl9 this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br /> <br />EX OUENCY <br />OF <br />r SAMPLE <br /> <br />TYPE <br /> ANALYSSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE _?c-I1 i'c Y <br /> MEASUREMENT <br /> PERMIT t=### si :: is b rc#### ?. O JL-EKL I NS ! i '. <br />Ray REQUIREMENT r1II? _I?t;M MAXIMUM <br />1 I E',L SAMPLE <br /> MEASUREMENT <br /> PERMIT 1?##1? #ta1F ??,K#?rs. E; II fdCEi GRAB <br /> REQUIREMENT MONTF <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT iF1F3t# # _- .ai##?c q REPORT >NCE/ FtALi <br /> REQUIREMENT LvLI P.tJG ILY MX MONTH <br /> SAMPLE I '. <br /> MEASUREMENT <br /> PERMIT r:x r#s" :t it# ####iF# 3000 E74?) 210 IWEI GRAD <br />!N REQUIREMENT 0AA A IU AILY MX ?1CINT' <br />iL, SAMPLE <br /> MEASUREMENT <br /> <br />71 <br />('r PERMIT f', e Q LF i r II _ riJ] <br /> REQUIREMENT I t•: S 1 f 1H x <br />1. ' SAMPLE <br />- MEASUREMENT <br /> PERMIT PORT <br />f 3RD:: REQUIREMENT '...'Y MX <br />T:7 AL. SAMPLE <br />L! MEASUREMENT <br />PERMIT ?. REPORT REPOR <br />REQUIREMENT SODA Atli DAILY MX <br />NAME/TiT•LE PRINCIPAL EXECUTIVE OFFICER t rtn' y =7 pins ty ° aw teat this document and ail attachments were TELEPHONE DATE <br />prepared under my direction or mpenhton In accordance with a system designed <br />to cart Thal qualintel personnel property gather and e•olusle the Inroemallm <br />m <br />In <br />ir <br />of the <br />o <br />b <br />itt <br />d <br />S <br />d o <br />a wh <br />th <br />t <br />pers <br />su <br />m <br />e <br />. <br />ave <br />n <br />y <br />qu <br />y <br />n or person <br />o manage <br />e sys <br />em. <br />' ' <br />" - <br />or those perm directly responsible for gathering the Information, the Information <br />- <br />submitted le, to the beat of my knowledge and better. 1r . accurate. and complete <br />w <br />i <br />nificaM <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />1 <br />m <br />r <br />t th <br />ni <br />r <br />ltti <br />r <br />t <br />Int <br />th <br />b <br />d <br />TYPED OR PRINTED g <br />a <br />a <br />a <br />e <br />a <br />en: are t <br />pena <br />ot wt <br />m <br />a <br />! <br />o.,. <br />", <br />es <br />ng <br />InehMing the poosiblllly of fine and Imprbonmenl for knowing ./olntho OFFICER OR AUTHORIZED AGENT AREA NUMKR YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Roforence aN attachments hors) <br />i F S(?!.-.DS LIMIT Apclf TFP Ff7)P 10Yr' f--' _ 1T <br />)r.; i TLIR ING - I. 01 i' <br />.;'?3i?? _ .: tra : rnr•, G3i-PilF7TC'n <br />.. p ._f form <br />EPA Form 3320-1 (Rev 3199) Previous editions may be used. 1S 1S 8: 1- 8 PAGE OF