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PERMrME NAME/ADDRESSpnrv*FwotyN.+?Le wi-t/D(Q6.w ) <br />NAME <br />ADDRESS <br />L6x ice, <br />G : 13 8 <br />FACILITY PER MINE <br />LOCATION I G co e <br />-,•MOND G. DU 131315, PRES/G <br />NATIONAL POLLUTANT DISCHAROE ELIMINATION SYSTEM NPOESI <br />DISCHARGE MONITORING REPORT /D R) <br />PERMIT NUMBER EIC.AEIGE NUMBER <br />MONITORING PERIOD <br />YE R MO DAY YEA MO DAY <br />FROM TO <br />Form Approved <br />OMB No 2040-0004 <br />DISCHARGE TO HURSE GULCH <br />NOTE: Road krntiructiora before'comohtirt9 this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREOUENCY SAMPLE <br /> OF <br /> EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT - sF:s •t s ##? s. >?### c =.. - H <br />c REQUIREMENT IJST MAX h1C1i`•%? <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />r` <br />1 <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT i <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER t certay under Rn• ty ° I.. th.I Ihh docomtnt and all ¦Ilachments were <br />TELEPHONE <br />DATE <br />prepared under my dlreclbn or wprnMon In aceordann with . fyrlem darned <br />to Aare that qualified personnel properly gallw and tvalusle the Informellon 4 - <br />?' submitted <br />owed on m <br />In <br />uir <br />r 01 a <br />r <br />o <br />r <br />h <br />pe <br />. <br />y <br />q <br />y o <br />son <br />r pe <br />sons w <br />o manage the system, <br />or than Persons directly nespondbk for gathering the Infonnalloa, the Information <br />i wbndlled Is <br />to the bat or m <br />knowled <br />- <br />e and b <br />li <br />f <br />tr <br />a <br />i <br />d <br />. <br />. <br />y <br />g <br />, <br />e <br />e <br />, <br />ue. <br />ccun <br />r, an <br />comlpkte. <br />1 am aware that ibe" are signlncant Penalties for.nbmtlfing fahe Information <br />SIGNATURE OF PRINCWAL EXECUTIVE <br />TYPED OR PRINTED _ , <br />Inchuling the "blillr or fine and Imprisonment for knowing rbl.tiorm OFFICER OR AUTHORIZED AGENT CODE NUMNER YEAR MO DAY <br />GVMMtr4I J ANV CArLAfl/n I non yr rs?.. .rvs.n n I <br />EPA Form 3320-1 (Rev 3199) Previous editions may be use <br />•?rmc. ern .et.cnm.nu n?r?1 <br />ABLE SOLIDS LIMIT APPLIED FOR <=IOYR,24HR PRECIP EVENT- <br />DS MONITORING - I. B. 2. <br />00460 is rf'":k.,?-Pan tOrn1. PAGE OF