Laserfiche WebLink
PERMITTEE NAME/ADDRESS(7oa6&PaeftNad/Lxarlon((DIO6?W) <br />NAME <br />ADDRESS;. <br />I .i B 0 X 463' <br />FAONIA co 81 <br />FACILITY ,- , .; r E NO 2 MINE <br />LOCATION UA co 81 <br />I r w•. rt r w rs IM art T t• t r^ M <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM JNPDES/ Form Approved <br />DISCHARGE MONITORING REPORT (OMR) OMB No. 2040 0004 <br />N I_ : I <br />PERMIT NUMBER DISCHARGE NUMBER - ; jNAL :.)ELF p <br />MONITORING PERIOD DEER TRi_ DTC OR UNMD TR I B <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />NOTE: Read Instructioca before COMPIeling this form. <br /> <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREQUENCY SAMPLE <br /> <br />EX OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT #jt?+x Kd_PL'i_ z c. <br />i> tt#itq## =? i EEKLY I ;-jil <br /> REQUIREMENT i NST Mr--, <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 />NAMERTTIE PRINCIPAL EXECUTIVE OFFICER t Cettay • r pen. ly o l.w that th <br />ared uraMr m <br />dirertbn aN wp <br />re b dcsurn at and all .luchm <br />enlslat In a[eordann w11A ents wen <br />• iysltm ddtned TELEPHONE DATE <br /> y <br />p <br />p <br /> to awun lhal qua111led perennnel properly Lather and evaluate the Info matlon <br /> sasmllted. Based on my Inquiry of the person nr pe oar whe maeaare the system, <br /> at those p riems dim,etly respo.dble for gathering the Informallen, the Informallon <br /> submitted M, b the best of my anawhdgt and belief, true, aeevrfle, and tomplrle. <br />SIGNATURE OF ?AINCWAL EXECUTIVE <br /> I am aware that then are slgnlfleant penalties for submittint Abe Information. A A <br />TYPED OR PRINTED InAuding the poadblllty of one and Imprbonmenl ror knowing Aoletlorea OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Hsforenc• M •ttecnmonts nerel <br />-1 r r,rr,;r 7c- - ATMrr) T>• ?? aTr AP°ROV=TI Py WC?t^1?, <br />EPA Form 3320-1 (Rev 3199) Previous editions may be used This is a 4-part form PAGE OF