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PERMITTEE NAME/ADORESS (T c" FroyNai.WL«ati a t(DI wow) <br />NAME <br />ADDRESS <br />L LJ Ji 4 ti <br />I A CO 81426 <br />FACILITY E NO. 2 MINE <br />LOCATION 4 I A CO 81428 <br />I TAM A P. FAR .1R , M T NF MAR <br />Form Approved <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM fNPOESI OMB No. 204 0-0004 <br />DISCHARGE MONITORING REPORT /DMRI T <br />(3UBR MH) <br />PERMIT NUMBER DISCHARGE NUMBER F - FINAL DELTA <br />MONITORING PERIOD WWTF TO DEER TRAIL DITCH <br />Y O D Y O D 6Y <br />FROM TO - - <br />NOTE: Read Inetrvctiorw before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. tnEGVENCY <br />OF SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT - <br /> PERMIT # # z ?: # at # it Zt;t It # x X 1 OPTIONAL 777,777 ._ <br />31 W, REQUIREMENT 30DA AVG MX 7D AV M W T H <br />?- SAMPLE <br /> MEASUREMENT <br /> PERMIT -r r ?! ## # 3! ## <br />r_f REQUIREMENT 0 D A r, .> MX 7D AV f_% ;TH <br />r SAMPLE <br /> MEASUREMENT <br /> PERMIT 11 J = L I I— <br /> REQUIREMENT rMINIMUM MAX I MUM -: <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT i lum <br />_ <br />=,; INf _•; , - REQUIREMENT '-Ot7a AVG MX 7i7 AV <br />TT-1 I A SAMPLE <br />![ f.U MEASUREMENT <br />c7 PERMIT .: <br />p' <br />' <br />r R05- REQUIREMENT :,DA AVG f1X 7G AV 1 <br />t <br />- SAMPLE <br /> MEASUREMENT <br /> PERMIT _ _ , -. . ; . •, <br /> REQUIREMENT INST MAX <br /> SAMPLE <br />7 17 <br />t <br />MEASUREMENT <br /> <br />PERMIT -. , .. <br />REQUIREMENT DA r"'•'.", iILY MX UOU <br />NAME/TiTLE PRINCIPAL EXECl1TfVE OFFICER I ceri y r rKkf penally o I.w th.t .11 do[vment end .M attachments were TELEPHONE <br />prepared under my direction or mpe. on In accordion with • system designed DATE <br />to Rare that gaaMfted personnel is Ay [other and -sluste the information <br />a.hmilied. !steed on my Inquiry or the person or person( who manage the system, - <br />f <br />th <br />dire <br />tl <br />oteelbi <br />athe <br />i <br />I <br />f <br />th <br />inf <br />th <br />d <br />ti <br />' <br />or <br />ou persons <br />y resp <br />or g <br />r <br />ng <br />e <br />n <br />onma <br />oa, <br />e <br />orma <br />on <br />c <br />e <br />f <br />k <br />h <br />t <br />wl <br />d <br />d <br />W <br />l <br />d <br />my <br />no <br />e <br />submitted Is, to t <br />e hes <br />o <br />ge an <br />, lrwe, accvrs <br />e, an <br />complete. <br />bt <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />i _ <br /> 1 .m were that there see sign <br />ficant penaMhs for submitting ratfe Inform.clon, A A <br />TYPED OR PRINTED Including the possibility of Mar and Imprisonment for knowing eloi.tlons OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION yr ArfT vi%JLAtrvrna irTararance am ariacnrn.nra r1wrter <br />£NSTRUCTi?ir.i?_- - I C 10, PG. 10 <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used OC 3 4 5 / OIUf.W A 4 -pSTt (prin. PAGE OF