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PERMITTEE NAME/ADDRESS p?L?r F.rwryN..?t err,en l/D{Qi..,.r) <br />NAME = R <br />ADOREss -R <br />BOX 1 <br />IG CO 81 <br />FACILITY 'PER MINE <br />LOCATION .1G CO 81 <br />`r MOND G. DU BO I S, PRES / Gt' <br />NATIONAL POLLLITANT DISCHARGE ELIMINATION SYSTEM NPOES/ <br />DISCHARGE MONITORING REPORT (D R/ <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY [YEAR MO DAY <br />FROM TO <br />Form Approved <br />OMB No 2040-0004 <br />MINOR <br />(SUBR aJC ) <br />F - FINAL <br />POND #2 TO EAST PYEATI <br />NOTE: Read Instrvctione before completing this form <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREOUENCY SAMPLE <br /> 1>< OF <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX A NALYSIS TYPE <br /> SAMPLE <br /> MEASUREMENT <br />i <br />- PERMIT #il : ? POR. u #### ## tr im # FEF(Lti. . i S, <br />U1=t; REQUIREMENT i 04- MAX <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 /> SAMPLE - <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I f n"y " er pens ty o sw that thh doeumenl and of attarhrnent. were <br />Prepared ".der my direrilun or superehlon In sceanlarnce with a sysienn designed <br />! <br />TELEPHONE <br />DATE <br />+ to smrm that qualified personnel properly gather and evaluate the Infnrnallon <br />submitted. Bred on my inquiry of line person er persoro who mana <br />e the s <br />stem <br /> g <br />y <br />, <br />or those peetaera directly reeponWW for plhering the Information, the Information <br />- -- - % ?„ `-'1`-- <br />_ <br /> subrdtied Is, to the belt of my knowledge and belle(. troe. accurate. and complete. 4 <br /> 1 am swan that there are slgnincant pretaliib for nbmitdng false Information, SIGNATURE OF PRINCIPAL EXECUTIVE <br /> <br />TYPED OR PRINTED <br />Including lM posibinty orfiae and Imprisonment for knowing vlolauoem <br />OFFICER OR AUTHORIZED AGENT <br />CARE I <br />ODE NUMBER <br /> <br />YEAR <br /> <br />M DAY <br /> <br />GUMMtN I s ANU tAYLANA I IVPt yr Are T V IVLA I Ions rfferorence, aff afrachmonts flare/ -- <br />I?! r =OLIDS LIMIT APPLIED FOR '=10YR, 24HR PRFCIP I-VT-r•iT <br />TOR I Nr; <br />r At, <br />? _'„? irat y tvI frr?l? I Ftf=?!"IFiTF7 <br />EPA Form 3320-1 (Rev 3/99) Previous editions may be used. Th 1$ a<4-pao- orm. PAGE OF