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PERMITTEE NAME/ADDRESS(7m.6 rForo#y NaweWL-.Hom((D(Q:rs..r) <br />NAME LL ADDRESS <br />ti0k yi3 <br />A co 81S214 <br />FACILITY LANE CANTON MINE <br />LOCATION i`. ca S 1 S c 4 <br />LTER WHITLEDGE, MINE MGR. <br />Form Approved. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPDESI OMB No. 2040.0004 <br />DISCHARGE MONITORING REPORT W R) : NJ <br />, <br />`3UPf <br />PERMIT NUMBER DISCHARGE NUMBER - F I NAL GR F LE <br />,,,I0ERGROUND MINE TO E SALT Ck. <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />NOTE: Reed hutnictloM before eotirwletfna this form. <br />PARAMETER QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. FREQUENCY <br />SAMPLE <br /> OF <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX ANALYSIS TYPE <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT -: x # t #>f ## - <br /> REQUIREMENT j I`IM <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT 70 <br />UEPA REQUIREMENT ?liA 1) I <br />1X <br /> _ <br /> SAMPLE -- <br /> MEASUREMENT <br /> <br /> PERMIT 3500 -7 <br /> REQUIREMENT _ `FDA A DA T LY MX <br /> <br /> SAMPLE - <br /> MEASUREMENT <br /> PERMIT v. #e tt if n st T irir# t # it tt #?Fit tt#iF## ? L _( <br /> REQUIREMENT Ih1S : MAX UEI <br /> SAMPLE <br />_ MEASUREMENT <br />- PERMIT E C!+27 POR " #IF#9FiF# G#i <br /> REQUIREMENT 'iODA V,' - , : l_Y MX <br />J '. SAMPLE <br /> MEASUREMENT <br /><,F, 1 PERMIT .. _ J <br />_ REQUIREMENT T MAX <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER t fer''t' ° er pen• t` "f "' `""'n" d e11w"' a^d ?l •'tachmenU were <br />prepsrsd ender my dtrctkm or superrtoon In accordance with ¦ system designed TELEPHONE DATE <br /> to nsure that quamfled personnel properly Lather and evaluate the Information <br /> snbndlied. asa.d on my inquiry of the person or person. who manse the system. <br /> or those persoria directly respendbk for gath.d. j the Information, the Information <br />b <br /> <br />- su <br />mitted I& to the best of my km mledge and belief, true. scrcrratt. and complete. <br />I am .ware that there are dgrdflcamt penalties for sabmltttn <br />fate Inf <br />r <br />ti <br />aIONATURE OF PRINCWA <br />EXE <br />T <br /> <br />- TYPED OR PRINTED g <br />ma <br />on. <br />o <br />IrmludinE the poadblHty of nme and Imprisonment for knowing .bl.uorm L <br />CU <br />IVE <br />OFFICER OR AUTHORIZED AGENT <br />CODE NUMBER <br />YEAR <br />MO <br />DAY <br />Ir -RIOD REPORTED <br />EPA Form 3320.1 (Rev. 3199) Previous editions may be used <br />ASE - SEE I. B. 1. C. TDS MONITORI <br />This is a 4-pan form.