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PERMITTEE NAME)ADDRESS nnc&& Fwiko Nrn?L«atlan (/D($Wvw) <br />NAME <br />ADDRESS <br />BOX 187 <br />R A I G CO 8162,` <br />FACILITY r'7r--PPER MINE <br />LOCAT". IG CO 8162E <br />?Vtnnnln C-1 rill i3nTg PRF9/f=(1 <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM I/NPOESI <br />DISCHARGE MONITORING REPORT WWI <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMB No. 2040-0004 <br />MINOR <br />(SUBR JC ) <br />F - FINAL <br />WET TESTING FOR 023A <br />t, <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FIIEOUENCY <br />OF SAMPLE <br /> EX TYPE <br /> ANAlrsls <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />E SAMPLE <br /> MEASUREMENT <br /> <br />1 0 PERMIT ###### #?t### 100. 0001 ##3F#tE' riF## 4B <br />1 ?RCi: REQUIREMENT <br />11 VALUE <br />TATRE SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT #### a1### 100-0001 ##?t# #### - Y ARAB <br /> REQUIREMENT ?'i - VALUE <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT i <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT u ` <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 I n,Ioy ° of Pen't' ° .w that Ilah dorument and all .ttochmenu were TELEPHONE <br />in <br />e with a a <br />lem ded <br />ned <br />di <br />tl <br />er.ist <br />d <br />d GATE <br />n <br />g <br />on W mp <br />oo <br />accor <br />anc <br />prepared un <br />er my <br />rer <br />- to asrrre that quauflyd Personnel proPery talker and evaluate the Information <br />aubrNtted. lased on my Inquiry of the pen wC oe person who manage the rystem, i ?- <br />.c <br />- <br />_ <br />- <br />or thou persorot d+recty responlbk for gathering the Inrom atlor4 the Inrom"Ilen <br />ltnawkdge and brief <br />true <br />accurate <br />and complete <br />itt <br />th <br />best -(M <br />b <br />d u <br />t <br />, <br />. <br />. <br />. <br />e <br />, <br />o <br />e <br />/ su <br />m <br />Y <br />IGNATURE OF PRINCNAL EXECUTIVE <br />-- I am own" that then are 21011CAnt Pe kks for arrbmitting face Intormeam. S AREA <br />TYPED OR PRINTED <br />Including the Possibility of Ilm and Imprimament for knowing .iolatlont <br />OFFICER OR AUTHORIZED AGENT <br />CODE NUMBER <br />YEAR <br />MO <br />DAY <br />AT I <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lReference a!l attachments here) <br />F F P F) 7 1. CISC - STATISTICAL P 0 1 N T ESTIMATE WHICH IS <br />-'E 1 r EP9RT FORM Ti <br />ri - <br />EPA Form 3320-1 (Rev 3199) Previous editions may be used. PAGE OF