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PERMRTEE NAME/ADDRESS / ft.&*Fw WiYN-m(L«oti n yD(#Wow) <br />NAME <br />ADDRESS <br />i. BCJX JJJ <br />?MER.SET CO 814 <br />FACILITY INBORN CRK & ELK CRK MINES <br />LOCATION -''IERSET CO 814 <br />+MES T. COOPER, EXEC V. P. <br />NATIONAL POLLUTANT OISCHAAOE ELIMINATION SYSTEM /IIVPDESI <br />DISCHARGE MONITORING REPORT IDMR/ <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 />1,1A !JG <br />F - FINAL <br />SURF RUNOFF TO N. FK GUNIS RI'- <br />NOTE: Read Irntrucdtxw btefore eOmpleting this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREGUENCr <br /> <br />OF <br />SAMPLE <br /> EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ###### REPORT ## ;- = ale#### 3( ?1 ### ;NC / ! L `_ i ±=e! <br /> REQUIREMENT iNST MAX MONTH <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 /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAMEmnE PRINCIPAL EXECUTIVE OFFICER I nnrry under pen¦ ty o law Thal lh M document and an attachments were <br />TELEPHONE <br />DATE <br /> prepared under my direction or supr r?1/ In o-ordance with a syslem designed <br /> t <br />th <br />lifi <br />l <br />tA <br />IM I <br />t <br />d <br />t <br />f <br />-- personne <br />y ga <br />o assure <br />a <br />qua <br />e <br />Proper <br />er and eralualr <br />n <br />ernutbn <br />submitt <br />d <br />Band on m <br />In <br />uir <br />of the <br />erson or <br />erson wh <br />nona <br />th <br />t <br />m <br />, <br /> <br />L . <br />y <br />q <br />p <br />p <br />e <br />y <br />o <br />ge <br />e sys <br />e <br />, . <br />j or those Persons directly mpordbk for gathering the Information, the Information <br />` <br /> submilled Is. to the best of my knowledge and belief. lrw. accurate. and eoaplele. <br />w <br />ninrant <br />ension for <br />I am <br />th <br />t th <br />r <br />bmitti <br />r <br />ise I <br />for <br />i <br />ti <br />JlIGNATVEIE OF ?RINCI?Al EXECUTIVE ( r l r t J .. <br /> g <br />p <br />s <br />an <br />a <br />en a <br />e s <br />su <br />ng <br />a <br />n <br />ma <br />on. <br />TYPED OR PRINTED Including the possibility or floe and imprisonment for knowing riolatImm OFFICER OR AUTHORIZED AGENT CODE NUMEiER YEAR MO DAY <br />COMMENTS AND EXPLANA I IUf4 Ur nnT VIVLA I ivna fxararenca sit arracnmenr= neral <br />'_EABLE SOLIDS LMT APPL T L S, FOR '=10YR, 24HR PRFC I P «,'FNT; <br />?-V FRT -SEE I A. 1 <br />`S. <br />r i T r a t i : : , . ? r T.).,'- Alts, i ..? H T C <br />I- U1 <br />=tPTI) <br /> <br />EPA Form 3320.1 (Rev. 3/99) Previous editions may be used This4s,a 4- an-(qrm. <br />p PAGE of