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FERMITTEE NAME/ADDRESS(7nc6&faeieeyNwwa,LaerlwvVDWWwu) <br />NAME <br />ADDRESS <br />IIA CO 81428 <br />FACILITY ; E NO. 2 MINE <br />LOCATION ! IA co 61428 <br />.LIAM A. BEAR JR., MINE MGR <br />NATIONAL POLLUTANT DISCHAROE ELIMINATION SYSTEM NPOESI <br />DISCHARGE MONITORING REPORT f0 R/ <br />PERMIT NUMBER DISCHAAOE NuMBT <br />MONITORING PERIOD <br />YEAR MO YEAR MO DAY <br />FROM DAY TO <br />Form Approved <br />OMB No 2040-0004 <br />MINOR <br />(SUOR MH ) <br />F - FINAL <br />GSC GH Of' SR TO GUT <br />NOTE: Read Irntructione before completing this form <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREOOFNCY SAMPLE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX ANALYSIS TYPE <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT If##i( k# 6. 5: ##'}# :: ' U KL'' <br /> REQUIREMENT MINIMUM MAXIMUM <br /> SAMPLE <br />MEASUREMENT <br />I <br /> PERMIT it A- #### „ # 3t 70 WCE/ R <br />A <br /> REQUIREMENT 30GA AV0 A I L `/ I'1X MONTH . <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ####K: ##3r## ?h REPOR REPi i?' (t,E <br />' <br />;c REQUIREMENT <br />=TOGA <br />DA i LV I'1X . <br />110NTH <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ## IE?F#it # +? FdF# 3000 6000 'NC E- <br /> <br />REQUIREMENT <br /> <br />31 i"?C <br /> <br />GAILY MX . <br /> <br />?1{]t'•€ i <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT r c: r .r 10 <br />- <br /> REQUIREMENT <br />INST MAX <br />_riIT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT F POP T• REPORT ## I° ?r71 <br />^', ##>s <br />FIP <br /> REQUIREMENT _ti r. = I L.Y 11;t; <br /> SAMPLE - <br /> MEASUREMENT <br /> PERMIT # <br /> REQUIREMENT .,.:,4ST MAX <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER I cent y under pens t. o law that this dow"e"l and all attachments were TELEPHONE DA <br /> <br />Prepared under my direction or mpervlflon in accordance with a system designed TE <br /> to mare thal qualified personnel property Lather and evaluate the Information <br />lv bmllied. Based on my inquiry *(the person or persona who manage the system, <br /> or those persorw directly rnporedbk for fathering the Infermauo^ <br />th <br />I <br />f <br />ti - <br /> , <br />e <br />orma <br />n <br />on <br />b <br />. so <br />milted Is, to the best or my knowledge and beltf, Irve, a rare, and complete. <br /> I am aware Chat then are atgrdfkant Penalties for mbmitang faire Information, SIGNATURE OF PRINCNAL EXECUTIVE <br />TYPED OR PRINTED <br />nr a uv s Including the possibility of Mm and ImPrtsonrerent for knowing yldmtlores OFFICER OR AUTHORIZED AGENT COQ NUMBER YEAR MO DAY <br />COMMEN I.) AND CArLAren r rvn yr nre r ?rvLA t rvrta fRI/a/Mca off arfachmanis he/a) - <br />PREC I P F=VFNT T'_-) CLA T MFD TT_ ALA I M APPROVE? R',' <br />EPA Form 3320-1 (Rev. 3149) Previous editions may be used. Tbig !S, A 4-part form. PAGE .OF