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FERMITTEE NAME/ADDRESS(/ai.&Fer&ty Nm.arLeewit $fD(Qi.wu) <br />NAME <br />ADDRESS <br />BOX, 44 -3 <br />IA CO 8!428 <br />FACILITY E NO. 2 MINE <br />LOCATION !A CO 81428 <br />i T I, M A n r_ A n tcf Put T .'r 11-M <br />NATIONAL POLLUTANT DISCHAAGE ELIMINATION SYSTEM /INPOESI Form Approved. <br />DISCHARGE MONITORING REPORT (DMR/ OMB No 2040-0004 % 1.,, <br />PERMIT NUMBER DiSCHAAGE NUMBER - F 1 IVAL <br />L <br />MONITORING PERIOD DEER TRL DTC OR UNMD TR I 3 <br />YEAR MO DAY YEAR MO DAY <br />FROM TO - I d NATF• R..A "tnieti- h.f-. rnr•...I,otlesn this f-- <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, UFNCY <br />FREO <br />a SAMPLE <br /> O <br />F <br />R( <br /> <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS EX S <br />ALYSI TYPE <br /> SAMPLE 4- <br /> MEASUREMENT <br /> PERMIT <br />x <br />9 c" <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT x <br />': I`J Y: REQUIREMENT <br />_ SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />t PERMIT !7- -hl if, p <br />- <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />_j:.? <br />REQUIREMENT <br />= SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER lhb t <br />nfl <br />tod oil .11- <br />h <br />were <br />menLf <br />on that <br />' <br />t <br />• <br />l <br />TELEPHONE <br />DAT <br /> m <br />. wli <br />W*ninaceu <br />mP. <br />rod under m <br />dlrect <br />l <br />co <br />P 7 per eflon rdanfe wiyesitned <br />h. f <br />sem d E <br /> le!sure Mot tiuaNfied personnel property gather and e•ahiale the Information <br /> owbmilled. Bowed on my Inquiry of the Person or persom who man.te the fyflem, - <br /> or lhon persors directly respordblr for gathering the Inform.llost, the Inrormolion <br /> submitted K to the best of my bnowkdge and belief, true, n role. and tomPkle. , <br /> 1 .m .ware that then am sigrdfkanl Penalties for .ubmitting ralu Infortmtfon, SIGNATURE OF PRINCI?AL EXECUTT/E ' - <br />TYPED OR PRINTED Including the powilbnlty of nne.nd Imprisonment for knowing erol.tlonm OFFICER OR AUTHORIZED AGENT AlEA NUMBER <br />CODE YEAR MO DAY <br />I.NMMCre l J nnv ?r.r v+r•r..,.... ... ..... .... ?...,... •.. Ir.wrwrwrr.•w wr wflw..r.r rrwrrla ruwrwr <br />F'.IT:r Tr TM* T: *! r i T4+ - r'(1?'c. ..J?._r? <br />t <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used This is a 4-Part form. PAGE OF <br />