Laserfiche WebLink
FERMRTEE NAME/ADDRESS 17n&,4 i iwty v .?L anew (fDWWwo) <br />NAME <br />ADDRESS <br />BOX i87 <br />'G CO 81 <br />FACILITY '3PER MINE <br />LOCATION - I G co 81 <br />YMOND G. DU BOIS, PRES/GM <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM //NPDESI <br />DISCHARGE MONITORING REPORT (DMRI <br />PERMIT NUMBER DISCHARGE HUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />b25 FROM TO <br />Form Approved. <br />OMB No. 2040-0004 <br />MINOR <br />(SUBR JC) <br />F - FINAL <br />WET TESTING FOR 020A <br />NOTE: Read kietruet)one before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, <br /> <br />EX FREQUENCY <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br />ASUR <br />M r3 !i? r ;.- x. l ) .: <br />/ <br /> ME <br />E <br />ENT - <br />L, PERMIT ia##### a>f!I# -,; 100.0001 ##+E#lFit ? ??? Y 'f-' >... <br /> REQUIREMENT .._ ,;. .: MN VALUE <br />1= SAMPLE <br /> MEASUREMENT <br />;•t 1. PERMIT #i #i?i #ifnti# 100,0001 #if i>if ?f?! it# 4r- 'I.R Y R <br /> REQUIREMENT MN ?iAi•_tJE "' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER t cerLir ° r pone ty o s. that this dorument and off attachments were <br />TELEPHONE <br />prepared under m <br />direction or su <br />ontslm In accordance with a s <br />elem dtsi <br />ned <br />DATE <br />y <br />p <br />y <br />g <br /> <br />i / <br />to tecrre that quaM W personnel property gather and t.aluele the Information <br />submitted. 6rM on my inquiry of the person or person who manage the system, i-C <br />or thaw persoro directly responsible for gathering the lnformauoft the informadon <br />b <br />th <br />b <br />t <br />f <br />kn <br />i <br />t <br />d b <br />t <br />wl <br />d <br />d b <br />l <br />! <br />t <br />/ ;. -• , su <br />m <br />e <br />o <br />e <br />es <br />o <br />my <br />ge en <br />t <br />, <br />o <br />e <br />e <br />le <br />. <br />rue. accuraw and cmnplNe. <br />I am own" that three are si <br />ninont <br />ertaides for s <br />bmittin <br />raise Inf <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />ti <br />n <br /> g <br />g <br />p <br />u <br />orma <br />o <br />. AREA <br />TYpED OR PRINTED lndudlnt the possibility of Mae and ImpAsot n e for knowing Aoistioms. OFFICER OR AUTHORIZED AGENT CODE NU ER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Reference eN o"echments here) <br />R <br />7 1. TA?"TST'CAL i''-?;i`JT r'_ <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used } ¢ W4- Lj,f?(iil. PAGE CIF / <br />i /