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PERMITTEE NAME/ADDRESS pw h,* Forary Na.?Lec.etaw vD(QGewv <br />NAME <br />ADDRESS <br />:;NIA C <br />FACILITY •J I E NO. <br />LOCATION' =1N I A C <br />fLLIAM A. BEAR •JR. : MI <br />Form Approved. <br />J NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPOESJ OMB No. 204040004 <br />DISCHARGE MONITORING REPORT ID R1 <br />PERMIT NUMBER ascHArof Numsm F - F i NAL DELTA <br />i MINE DRAINAGE TO GUNNISON PRIV <br />MONITORING PERIOD <br />D 61 G Y R DA YEAR O D Y' <br />FROM TO _ <br />NE MG NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREQUENCY SAMPLE <br /> <br />EX OF <br /> ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT r'+ tt3F r rit ;= ! <br /> REQUIREMENT k MINIMUM MAXIMUM <br />- SAMPLE .. ,. - <br /> MEASUREMENT <br /> <br /> PERMIT <br />Ji:=iJ : REQUIREMENT 30DA A'JG DAILY N X <br />r H <br /> SAMPLE <br />( AS F MEASUREMENT <br /> <br /> PERMIT <br />it -5, 77IF 2 <br />-P, <br />.J• <br />. - i <br />G,F(L::_ REQUIREMENT 30DA A`1r DAILY MX MONTH <br />_ .. .- SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT' - r <br />?JF='v REQUIREMENT 1,NST MAX CENT <br /> SAMPLE <br />' MEASUREMENT <br /> <br /> PERMIT' _ . t (, st r. -, <br /> REQUIREMENT `DA r=. `J (; DAT<._`I' NIX <br /> SAMPLE <br /> MEASUREMENT <br /> <br />1. PERMIT „ .... _ e .. . . <br />t REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />" r pen. y 0 fa. that this doc"manl and an attachments <br />were - <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER t <br />TELEPHONE <br /> <br />DATE <br />mpar <br />ed ¦nder my direction or SUP-0sh n In accordance with a system ddgned <br />to sasu <br />to wore Ihal 9-Hritd personnel VOWHy 9a111wr and ..Juale the Infiwenation <br />submitted. Bred on my inquiry of the perms a penom who manase the syslem, <br />or those p? dlrxty r -W-91bie for 9.1h,,i tt IM InformaUow. the Information ...e.c{Z' <br />mbmilted Is, to the best of m7 knowledge ¦nd beNef, true, accurate. and -mpkle. _ <br />I sm - are that thus 21 sitnIM-1 Penafrfa for rubmtt8ng fahe +n a-lion <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />- <br /> . <br />tr <br />l <br />h <br />lbuIt <br />f fi <br />M I <br />dl <br />i <br />f <br />k <br />TYPED OR PRINTED r <br />u <br />ns t <br />f o <br />mpr <br />e po. <br />res s <br />sonment <br />or <br />mwing •"ation, OFFICER OR AUTHORIZED AGENT COOS NUWSER YEAR MO DAY <br />COMMEN 15 ANU t ArL.ANA l lvn yr Pt" e v out n r tuna rnvrrrtrnvw wn wu.crunwnta n.rq <br />INSTRUCTIONS <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used <br />10, PG. 10. <br />0049:1, • `Tftf:,* & 4-part fdrm.