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PERMITTEE NAME/ADDRE&Spw.6&F-oryNaw?Locwi-I/n(p6-1) <br />NAME <br />ADDRESS <br />BOX 48:3 <br />i.V I A CO 81428 <br />FACILITY )1E IND 2 MINE <br />LOCATION .'NIA CC) 91428 <br />i_LIAM A BFAR JR MINE MGR <br />NATIONAL POLLUTANT DISCHARGE FLIMINATION SYSTEM /NPOES) <br />DISCHARGE MONITORING REPORT (D MR) <br />PERMIT NUMBER DISCHAROE NUMBER <br />MONITORING PERIOD <br />YEAR M OAY YEAR MO D 6Y <br />FROM TO <br />Form Approved. <br />OMB No. 2040-0004 <br />N 1 N t i R <br />11 SUBP t !?! <br />F - F=INAL DEL 1 <br />DSCHG OF SR TO GUNNISUN RIVER <br />NOTE: Read Inotructlorle before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br />EX FREOUENCY <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE :. <br /> MEASUREMENT <br /> PERMIT „Ef ' #IF### ?? f:: 35### ?i C A' <br />_ REQUIREMENT ! NSi MAX <br /> SAMPLE <br /> MEASUREMENT <br /> <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 /> <br />NAME/TME PRINCIPAL EXECUTIVE OFFICER ' renrly a gene ty .(I.- Ih.l thh doromenl and all ut-hmenU were TELEPHONE { <br />DATE <br />Prepared under my dIrwIlon or mper+INon In accordance with ¦ system dglgned <br />to enure Ihm quaNfkd personnel property rather and eeaaualr the Information <br />mitmltted. Based on my Inquiry of the perw or persona who manage the system, <br />dire <br />tl <br />m <br />orMble for <br />atherin <br />the Information <br />the Infor <br />ati <br />th <br />r <br />c <br />n - <br />y <br />p <br />g <br />or <br />ose pe <br />se <br />s <br />c <br />g <br />, <br />m <br />o <br />- ' <br />submilleA K to the best of my knowledge and bane!, tnre, atcvnte, and complete. <br />SIGNATURE OF PRINCWAL EXECUTIVE ' <br /> I am swan that then are slgrclncaM Penalties for mbmltting roin lnformatbn. A A <br />TYPED OR PRINTED InAuding the possibility ofnne and Imprbonmenl for knowing rlolaUoem OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION VI- ANT VIVLA I IUNS rxererenc• an erTecrImenri nerei <br />ac PRFC IR F`JFN IS CL_AIf1ED. IF CLA T M APPROVED BY WQCD, <br />,- <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used - - - " TFuS.IS 3 4-part form. PAGE _OF