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rERMITTEE NAME/ADDRESS(7-c&klaellrryAVaeaa?L«wir ?D(fi o) <br />NAME <br />ADDRESS <br />DUX !B7 <br />i G C Ci 8 I <br />FACILITY rO P ER MINE <br />LOCATION (G co 81 <br />?Mnrln n r111 T.IPITGi G PCcz/(_`M <br />NATIONAL POLLUTANT OISCHAAOE EUMINAT10N SYSTEM (/NPOES/ <br />DISCHARGE MONITORING REPORT (DMRI <br />FROM TO '. -1 1 Form Approved. <br />PERMIT NUMBER DISCHARGE NUMSER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />OMB No. 2040-0004 <br />MINOR <br />(SUER JC) <br />P - FINAL MOFAT <br />OT CHARGE TO EAST FLUME GULCH <br />NOTE: Read kretructione before c' ompletin thls tam. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br /> <br />EX Fit"MNCr <br />Of SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ## #ic tt IEfi ?• ; a_" st#?t sr 9.0 <br /> REQUIREMENT # MUM MAXIMUM <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT tt###?: its#ic- #ait 1?3t 3S 7 _! GRAB <br /> REQUIREMENT ;•'??N'T? <br />?r SAMPLE <br /> MEASUREMENT <br />_ PERMIT ??ic;? s£ fl # # #3 Al ' ;- DIE sF OPTIONAL REPORT GRAD <br /> <br />__FN REQUIREMENT 30DA Abr DAILY MX <br />rION'T}' <br />1'' • Tl: SAMPLE <br />(r; MEASUREMENT <br /> PERMIT n ! at ###### tt tt### 3000 6000 JNCE/ GRAS <br /> REQUIREMENT 3 WA AVG DAILY MX :,%; : rlpf,1"rl <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT MAX i <br />I RCN'. <br />c)' SAMPLE <br /> MEASUREMENT <br />MEP <br />0 PERMIT RE}... RE=PORT <br />gRDcS REQUIREMENT -.OJT'<, _ : ?IL? M <br />( -_ TA L SAMPLE <br /> MEASUREMENT <br />PERMIT tt tt stiE t- i #'?'' * REPIFIR T T Tf I_ Y , •. -': <br />REQUIREMENT -3ODf, DAILY MX <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER t can iy " er pen' ty ° aw that Mh document and all attachments wen <br />TELEPHONE <br />prepared coder my direction or suprr.Mon In eccordann with • rystem darned <br />DATE <br />- to asar, that qusMned personnel property Lalher and evaluate the Information <br />I <br />i <br />f th <br />/ <br />b <br />d <br />- <br />- <br />ry, o <br />" <br />subtrtltted. <br />ase <br />on my <br />nqu <br />e person or persons who manage the system, <br />or those pe sore directly responsible for gathering the Inferna low, the Information / - - - <br />t <br />t <br />f <br />k <br />wled <br />t <br />b <br />itt <br />d h <br />th <br />b <br />d b <br />li <br />f <br />t <br />d <br />l <br />t <br />e <br />ea <br />o <br />my <br />no <br />ge an <br />rue, scavra <br />e, an <br />su <br />e <br />, <br />o <br />e <br />e <br />, <br />comp <br />e <br />e. <br />m <br />SIGNATURE Of ?RINCIPAL EXECUTIVE . <br />itl <br />i <br />t <br />t <br /> I am aware that there are s <br />gn <br />un <br />penalties for submi <br />ting raise Information, AREA <br />TYPED OR PRINTED _ Including the possibility or one and Imprisonment ror knowing violsUmes. OFFICER OR AUTHORIZED AGENT CODE NUM[iER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF AMT VIVLA I WNb fmorarance an arracnmenra neray <br />1•,; it LE Pr". + r?S L I t`1I T APPI_ T ED FOR <= I OYR, 24HR PRFC I P EVENT - <br />?, C;REASE - SEE <br />r11.JCC Y-JdrlAlTLl1 _ <br />v 1- LIT <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. <br />00737/UW6is;a-14-past;9nn rAruc