Laserfiche WebLink
PERMITTEE NAME/ADDRESSpnab?rfewryN??L«rtewl/D?Qi..eU <br />NAME <br />ADDRESS _ <br />BOX 167 <br />.'. G CO 616; <br />FACILITY =PER MINE <br />LOCATION ? G co Bib; <br />'.rMf lnm n TI 1 7Dr'i 7C E30=q /r%m <br />NATIONAL POLLUTANT OISCHMOE ELIMINATION SYSTEM I/NPDESI <br />DISCHARGE MONITORING REPORT IDMRI <br />PERMIT NUMBER F11C.A10E NLWOER <br />MONITORING PERIOD <br />YEAR MO <br />FROM DAY TO YEAR MO DAY <br />Form Approved. <br />OMB No 2040-0004 <br />MINOR <br />(SUBR JC) <br />F - FINAL <br />ACUTE WET TESTING FOR 019A <br />NOTE: Read Instructions before Completing this form. <br /> <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. rnEOUENCY <br />OF SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> ' <br /> PERMIT # #x # ## - 100. 000 i # ?r## ;. ### s <br />RA; <br /> REQUIREMENT MN VALUE <br />:. SAMPLE - <br /> MEASUREMENT <br /> ' <br /> PERMIT Ott # K ## ;t### rt 100. 000 # ## > s ? tt # ;f ? ; <br />( ? I =' i' <br /> REQUIREMENT E , i <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT I <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />E <br />T <br /> REQUIR <br />MEN <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER ' R"' 7 ° 'w that `"`' document and all attachments were TELEPHONE <br />prepared under my direction or supereMoo In accordance with a system darned DATE <br />to ssum that quahArd personnel propeel7 Lather and eeahsale the lnformatlon <br />submitted. laved on my Inqu1r7 of the person or persona who manate the system, ` <br />/' or thaw persons directly msponlW for gathering the Information, the information -- <br />' <br />" <br />t <br />l <br />. - ." <br />h <br />f <br />k <br />l <br />d <br />d b <br />f <br />t <br />l <br />d <br />l <br />t <br />. . . <br />o <br />my <br />now <br />ge an <br />. <br />rue. aecum <br />e. an <br />comp <br />e. <br />i submitted Is, to t <br />e bes <br />e <br />e <br />e <br />e <br />TURE OF MIINCWAL EXECUTIVE <br /> I am aware that there are dgnincanl pendtla for subrnkting (aim Informadon, SIGNA AREA <br />NUMBER <br />Y <br />TYPED OR PRINTED Including the Possibility or Mae and Imprtsunment r« knowing elolsoors. OFFICER OR AUTHORIZED AGENT CODE EAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference aN attachments haral <br />F*"rIRT l_CSO - STATTSTICAL POINT ESTIMATE WHICH IS <br />EPA Form 3320-1 lRe: 3 90; orencus ed,To^s mar be _sed This 15 a 4-Purl form PAGE OF