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PERMITTEE NAME/ADDRESS Qmebt4 iaolbq Nwarrl arrlow f/D(Qkrerv) <br />NAME <br />ADDRESS <br />BOX 187 <br />IG CO 8162E <br />FACILITY PER MINE <br />LOCATION I G CO E3162 E <br />,..ne..? .. ..r-.vn nnrr+ rnwe <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (/NPoESI <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE IIVMeER <br />MONITORING PERIOD <br />YEAR ??Fn YEAR MO DAY <br />FROM TO <br />Form Approved <br />OMB No. 2040-OOD4 <br />MIN <br />- FINAL MOFAI <br />DISCHARGE TO DEAL GULCH <br />NOTE: Read Instructions bafcwo co lating this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, <br /> <br />EX FREOUENCr <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT xar#### DIE#t a. 5 ,- `" 9. 0 <br /> REQUIREMENT i < I: <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT 70 MCI:- <br /> REQUIREMENT MONTH <br /> SAMPLE <br /> MEASUREMENT <br />?, C1 PERMIT ; , #### # # #az ae# j PT AI_ RE .ORT -N I ! G P 2 <br /> REQUIREMENT 3taDA A':' J -,A I LIY MX I ,ONT <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT fi?•# i `' # ### it )E#ft#i ?iClUV tyVtlll i?? "! .;=? <br />lU i REQUIREMENT 30UA AV f?AILY MX 1' IN7 <br />l i) r SAMPLE <br /> MEASUREMENT <br /> PERMIT f- .: ,. „ .rz I...r. a` to <br /> REQUIREMENT I NS j 111F+X iT <br />"I! 1.1 SAMPLE <br /> MEASUREMENT <br />LJ PERMIT REP R-j REPORT dF##et ' ; ?s t< gat <br /> REQUIREMENT ; <br />SUP F RAIL" MX <br />i L V. + • • <br />: <br /> SAMPLE <br /> MEASUREMENT j <br /> PERMIT I?rc <br />-? lF # x # # IE#a r REPOR> K P 4T i L :I <br /> REQUIREMENT JODA DAILY MX <br />NAMErnnE PRINCIPAL EXECUTIVE OFFICER I mnoy er penalty o low that th <br />di <br />tl <br />d b document and NI attachments were <br />dance with • s <br />mern desi <br />ned <br />ervisi <br />n I TELEPHONE DATE <br /> g <br />prepare <br />rec <br />on or sup <br />o <br />n accor <br />y <br />under my <br />_ <br />i _ to taum that qualified personnel properly gather and evaluate the Infnrnntion <br />submitted, Band on my inquiry of the per>at or persom who ma Late the system. <br />W chose persons directly neapornible For gathering the Inftt nannm. the Infonmatlnn <br /> <br />? <br />• <br /> <br />. <br /> k <br />owl <br />f <br />irre <br />accurate <br />and com <br />lete <br />d I <br />b <br />t <br />f <br />d <br />a <br />d b <br />li <br />b <br />itl <br />th ', <br />/ ; - • <br /> , <br />. <br />p <br />. <br />& to <br />ea <br />o <br />my <br />n <br />e <br />ge <br />n <br />e <br />e <br />, <br />su <br />m <br />e <br />e F PRINCIPAL EXECUTM <br />I <br />A <br /> I am aware that there are significant penaltln for submitting rain Inforvnatfon, S <br />GN <br />TURE O AREA <br />TYPED OR PRINTED Indtding the porbitiy of Mme and lmprlaomment for knowing .leladons. OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANA I IVra yr fir. r .rv?n ..vna inw,w wri, an, <br />ABLE SOLIDS LIMIT APPLIED FOR `=10YR,24HR PRECIP EVENT- <br />_ _ ; DS MONITORING - I . B . 2. <br />EPA Form 3320-1 (Rev. 3.'99) Previous editions may be used „ 699 n??+4 ?a(L fQflT1. PAGE OF