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FERMITTEE NAME)ADDRESSpneYfrlacWryNwarLeeaelan{/DlSwewr) <br />NAME <br />ADDRESS : . <br />7. BOX 98 <br />)i1A CO ° ?_.a4 <br />FACILITY _ LANE CANYON MINE <br />LOCATION : lA CO 81'__,24 <br />;;I TFR LJHTT1 Fnt_F=. MTNF MaR <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM /INPDESI <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER NSC14AAGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMB No. 20404004 <br />MINOR <br />(5UBR UW) <br />F - FINAL <br />UNDERGROUND MINI <br />NOTE: Reed Irntructlone before cdre?pleting this forma. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br /> <br />EX FREOUENcY <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br />..> <br /> MEASUREMENT <br /> PERMIT ##tt - 5. 5 ###-; 5'. O <br /> REQUIREMENT MINIMUM MA X I t" il_IM <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT iFiFs: ?9t# = r# 3f - 'i !Cc- <br /> REQUIREMENT :;ii:? f ii ', :• Y 110t d Tr <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT #IFII 3'##!< t ##;e'Fu;{ 3500 7000 NC E. 9+= <br /> REQUIREMENT 30DA `` GAILY MX <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT 3E';. ='. t i{ ###iE IP####it lF#iEiFi 10 jN1-I Gvi:i <br /> REQUIREMENT 7 NST i 1A X <br /> SAMPLE <br />i REA ; MLN T i- . MEASUREMENT <br />0 PERMIT OR I <br /> REQUIREMENT n ,' ,q T L Y NIX <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT f#'t c REP <br />'?RY <br />i <br /> REQUIREMENT :R <br />; <br />a It_.Y f'!X <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT # 't ";-PORT ... <br />REQUIREMENT MAX <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER I nmim y under pens ly o aw that this docvmcnl and all atlKhmenb were TELEPHONE DATE <br />prepared under my dimcdon or supervision In accordance with a system designed <br />to asum that qualltled personnel property gather and evaluate the lnfermatbn <br />-1 ? <br />S •-';,` . <br />,r .'!?__ submitted. Based on my Inquiry of the person or persons who manage the system, <br />. <br />_ <br />tl <br />d <br />f <br />I <br />-" <br />or those perfume <br />lmc <br />y responsible <br />or gathering the <br />nrormatlon• the Information <br />t <br />b <br />t <br />f <br />k <br />l <br />•.• <br />?? /.• ?? i <br />" <br />L <br />( <br />submitted Is. to <br />he <br />e <br />o <br />now <br />edge and belief. true, sctursly. and complete. / <br />my <br />- mJ <br />aw <br />re th <br />n on si <br />I <br />S ONATURE OF PRINCWAL EXECUTIVE <br />I <br />t th <br />rsifl <br />a <br />t <br />lti <br />f <br />b <br />itti <br />fal <br />f <br />d / <br />j (?.•- <br />: <br /> g <br />am <br />a <br />a <br />e <br />c <br />n <br />pena <br />or su <br />m <br />ng <br />se <br />n <br />ornu <br />on, <br />es <br />TYPED OR PRINTED Incleding the possibility of fins and Imprisonment for knowing violsllome. OFFICER OR AUTHORIZED AOEffT CODE NUMEtER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference off efbchmenfs here! <br />NOD REPORTED. <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used. <br />OIL & G EASE - SEE I. B. 1. C. TDS MONITOR] <br />Tbisjsa4mpaytfOrm. PAGE