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FERMITTEE NAME)ADDRESS(Ineh4Faefhey Nm-WLararto IID(Qbenh) <br />NAME <br />ADDRESS <br />?. BOX 483 <br />?N I A CO 814; <br />FACILITY !W I E NO. MINE <br />LOCATION _tN I A CO 814, <br />_LLIAM A. DEAR JR MINE MGF <br />Form Approved. <br />NATIONAL POLLUTANT OISCHA IOE ELIMINATION SYSTEM (INPDESI OMB No. 2040.0004 <br />DISCHARGE MONITORING REPORT WMR) <br />PERMIT NUMBER DISCHARGE NUMB E11 - FINAL DELTA <br />MONITORING PERIOD !A OF SR TO OUNN I SON R I VF f' <br />YEAR MO DAY YEAR MO DAY <br />FROM TO r k tat <br />NOTE: Read Instnictlorw boforo comploth?p this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREOUENCY SAMPLE <br /> OF <br /> EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE „ <br /> MEASUREMENT <br /> PERMIT 3E### ## - 5 #### 4 <br />G <br /> REQUIREMENT . <br />MINIMUM . <br />M I MUM <br /> SAMPLE <br />MEASUR <br />M r; <br /> E <br />ENT <br /> PERMIT <br />#re r <br />><??tEit## <br />i?#3r <br />:IS <br />`_:' <br />s?F,:' <br /> REQUIREMENT "'06.)A AVG i _ ; ! a 1 :IfJ T i 1 <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT *iEai### ##it st## ##sFiE#!t REPORT REPOR 1 NCE/ =RAP <br /> REQUIREMENT 30D/4 <br />DAILY Mx <br />11"INTH <br /> <br />t. SAMPLE <br /> MEASUREMENT <br /> PERMIT 9t####1F ##1F## it If##iI# 3000 0000 !`i E! .:?r=?. <br /> REQUIREMENT , <br />30DA AVtr <br />A I LY MX <br />- <br />riONTt ' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />TNST FAX <br />,•: i <br />CJ1?1fJli SAMPLE <br />LKLATMENT I':- MEASUREMENT <br />_, < ) PERMIT : ,:T F, 1-0RT is##te,}^ t: (:'J`. 1 <br />r <br />i- REQUIREMENT r,:=.1 L )' riX . <br />-?? SAMPLE <br /> MEASUREMENT <br /> <br />PERMIT <br />REQUIREMENT ; 1vST MAX <br />NAMEfnTLE PRINCIPAL EXECUTIVE OFFICER 1 ferltly under pent' tl ° I,. that As doe mrn' and oil attachments were TELEPHONE DATE <br />prepared under my dirertlon or supenMon In accordance with a System designed <br /> to amen that quahfkd personnel I, we.ly Lather and evaluate the information <br /> submllled. bawd on my Inquiry or the person or penal .he manage the "tem. - <br /> at thou persona dlrrcllf reeponsIble for gathering the Inice n,Uon, the Information <br /> submitted b, to the left or m7 knowledge and better. Irate, ,crorele. end complete. <br /> 1 am a.,rs that there am dgniflunt pen,ltle for submitting robe Information SIGNATURE OF PRINCWAL EXECUTIVE <br /> . <br />lnd'di <br />dblY <br />f fi <br />d I <br />l <br />th <br />f <br />TYPED OR PRINTED ng <br />e poa <br />ry o <br />ne an <br />mpr <br />fonment <br />or knowing violations. OFFICER OR AUTHORIZED AGENT CO E NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION Ur ANY VIULA I IUN5 /Rsferencs M sfrlcftmenrs hors) <br />4F? PRPr LP EVENT IS CLAIMED. F CLAIM APPROI,1Ff11 RV c.U7irD, <br />r:MENTS-SEE ? c F: ;F n i1,. ,E , <br />EPA Form 3320-1 (Rev. 3)99) Previous editions may be used TFUS i?a 4 'palT form. PAGE OF