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PERMITTEE NAME/ADDRESS(7-"F rOtyK-.?L«.11-JfDIdF-+) <br />NAME <br /> <br />ADDRESS _ <br /> AER CO S <br />FACILITY 1-)W`! O MINE <br />LOCATION '? E'q co S <br /> D, SANDER;. VP OF OP: <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM fNPOES1 <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMSEA <br />MONITORING PERIOD <br />YEA MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMB No. 2040-0004 <br />II3}t <br />• Firs;;;_ <br />?H RAY TO WORK AREA POND <br />^. <br />NOTE: Read Inetructlone before completing this form. <br /> <br />PARAMETER <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION NO <br /> <br />. <br /> <br />EX <br />FAEOUENCr <br /> <br />OF <br /> <br />SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> <br />i <br />REQUIREMENT <br />..'.? I F <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 mrtay wraW penalty o i.+ that this docvm-ri dl .n.chroc.ts -M TELEPHONE <br />E PRINCIPAL EXECUTIVE OFFICER <br />NA DATE <br />prepared under ray dlrwil-n or super.hton In actordance -Iih • system desdtned <br />ME/TITL <br />y r to asure that qualified P,--el property gather and ee.lu.te the Inrormallon i <br />submitted. Bred on my Inquiry of the person or persons who manage the system. <br />or thosr persnrr directly responsible for gathering the Information, the Information <br />, <br />to the bet of m knowledge and belie( <br />/ - submitted Is <br />Irue <br />accurate <br />and corn <br />kir <br />- <br />, <br />. <br />, <br />, <br />p <br />. <br />RINCIPAL EXECUTM <br />T <br />R <br /> 1 am aware that there are significant prnattlel for.abmatfing false Inrornrtlon. E OF P <br />SIGNA <br />U A A <br />TYPED OR PRINTED Including The possibility of fine and Imprfsonrnent for knowing •Iot.Uorm OFFICER OR AUTHORIZED AGENT CODE NUMDER YEAR MO DAY <br />COMMENTS AND EXPLANA I IUrd yr rtrf>r VIVLA I tvrla rner.r.nce, arrr.u.?rrrrr..rr n.r.? -1 HR Plot( ,-A'ENT IS C <br />EPA Form 3320.1 (Rev 3/99) Previous editions may be used <br />A ED IF CL-AIM AFPFjV'• <br />1 f 'C7 r ,pnFIu <br />i t <br />L Y <br />T'h1S'14 a 4-pan form. 0t <br />1±35; <br />T I? <br />? r L.l