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PERMITTEE NAME/ADDRESS (7.c6& Forlkry)Vo otLor«fen l/D(06wv) <br />NAME <br />ADDRESS <br />]. Bux 535 <br />.,ERSET CO 8143 <br />FACXI Y ADORN CRK & ELK CRK MINES <br />LOCATION ."ERSET CO 8143 <br />AMES T. COOPER. EXEC V. P. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOESI <br />DISCHARGE MONITORING REPORT IDMR) <br />r. <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved <br />OMB No. 20404004 <br />MINOR <br />(SUBR 1"1) 1 <br />F - FINAL ! h I S <br />DISCHARGE TO ELK CREEK <br />f t - <br />NOTE: Read Irletructiorn before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREO <br />U <br />ENCY SAMPLE <br /> X F <br />O <br /> E ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT sl c ;:: c # 6. 5 ## "u 9.0 NCEi NS I T <br /> REQUIREMENT Y s MINIMl.:;,i MAXIMUM MONTH <br />I) _, SAMPLE F ;. <br />P EN% MEASUREMENT <br />1 PERMIT It##*ftir #++###as itsi#?## 3S 70 JIVC _J - r <br /> REQUIREMENT _ 3':?1 rA P+':• MX 7A AV I1C-' i : MONTH <br />I AL SAMPLE <br />AS FE" MEASUREMENT <br /> PERMIT #1i 3l it## ###it?i# wii###s> 3000 !l, i <{aa <br />w;LN? REQUIREMENT 30DA AVG DAI1_Y MX MONTt- <br />.. SAMPLE <br /> MEASUREMENT <br /> PERMIT ##Itit## ##iEtF#!? ###3t ;' #iFiF#&# Y <br /> REQUIREMENT INS T MAX CENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT C-1 PR P O, T ._ r i s u a <br /> REQUIREMENT V I L'Y MX -IT <br />i.' - - - SAMPLE -• <br />L MEASUREMENT <br />-,6 1 d PERMIT u##ar+ r : t^. L-7 71 HT <br />=RU REQUIREMENT INST MAX <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER t - t"f and" P`na'" "T;- that 1hM 4.r1mcn1 and .u .nachrarmb were TELEPHONE DATE <br /> pmpand undtr my dlrt ikon or fuperHetoo In e.ccorditl wlnh ¦ a]atem dedtned <br />r •. <br />• to aaaam that quallned perwnnd pr"wily Sather and eealtrale the Information <br />int <br />b <br />d <br />D <br />d <br />I <br />- aa <br />m <br />e <br />. <br />ow <br />on reef <br />nquiry of the person or perasna who managt list gvlem. -- ? <br /> or those penme dimelly respetdble for Salhedng the Infor tfort, the Information - - <br />- - <br /> aubmltled la. to the bean of my krtuwIrelp and befier• Irrr, secvn/e. and aotnpMte. / / <br /> I am aware that there are litnlnont peaakles for aabmlmng rater tnrmmadoo, 41ONATURE OF PRINCWAL EXECUTIVE <br />TYPED OR PRINTED Inducting The poaalblllly of fine and Imprbort wret for knowing `•lolatlara OFFICER OR AUTHORIZED AGENT AREA NUMBER <br />CODE YEAR MO DAY <br />GUMMCN I J APIu [fir ter........... ... ..... .... ?........., "'.rv."_ an' w.r.....ne..rw rear .r <br />tH _• ::: PERIOD REPORTED. OIL & GREASE - SEE 1.13.1.D <br />EPA Form 3320-1 (Rev 3)94) Previous editions may be used. 0053c' _ TJI SIS•a;4-par( farm. PAGE OF