Laserfiche WebLink
PERMITTEE NAME/ADDRESS (tree..4faetr,ryNw.?teca,rawt/o(f-ww) <br />NAME <br />ADDRESS l` .'ate`. <br />;j. BOX S35 <br />1MERSET CO E <br />FACILITY NBORN CRK & ELI CRK MINES <br />LOCATION IIERSET CO E <br />raMES T. COOPER, EXEC V. P. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPOESI <br />DISCHARGE MONITORING REPORT (D RI <br />PERMIT NUMBER DISCHMOE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />MINOR <br />(SURF MHi <br />F" - FINAL <br />SEDIMENT PON <br />Form Approved <br />OMB No 2040-0004 e <br /> <br />NOTE: Reed Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREOUENCY SAMPLE <br /> <br />EX OF <br /> ANALrsIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT REPORT 1 <br /> REQUIREMENT INST MAX <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 />I u er pen. ty d I.. that thh dorument and .It .ttachments wen <br />NAMElTITLE PRINCIPAL EXECUTIVE OFFICER <br />TELEPHONE <br />DATE <br />d undtr my direction or supenisbn In a rdanre with • sntem designed <br />re that queAnW personnel property gather and evaluate the Inrorwolion <br />ed. Based m my Inquiry or tin Person or persons who man.?e the system, <br />tl <br />f <br />di <br />b <br />persona <br />rec <br />y respo.W <br />k <br />or [.thertn6 the Inrorwmtim. the Inrormad n b <br />to [be bat of m <br />knowkd <br />nd b <br />li <br />I <br />f <br />l <br />d <br />l <br />y <br />, <br />re a <br />e <br />e, an <br />e <br />. <br />me.. ru <br />comp <br />ete. u.t Ibdrnln...I <br />-Ifirs rer rub rJttin <br />W- i„roen? <br />SIONATURE Of PRINCIPAL EXECUTIVE <br /> p <br />r <br />. <br />TYPED OR PRINTED c ,nr ?t?cw. ^f n„r -d iR pre o • fo, t?,<-t 0MCF R OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reforenc• sM o"schments horej <br />7T, 'r <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. `TWs lS.B 4-' jgrrn. PAGE OF