Laserfiche WebLink
PERMITTEE NAME/ADDRESSp-6+forib4N-?LocWt«n((DW-ww) <br />NAME <br />ADDRESS <br />?u:i 167 <br />IG CO 8162E <br />FACILITY '-PPER MINE <br />LOCATION ' I G C0 31621E <br />rmnND G. DU BOIS, PRES/GM <br />NATIONAL POLLUTANT DISCHARGE EUMINAT10M SYSTDA /INPOES) <br />DISCHARGE MONITORING REPORT IDAIRI <br />PERMIT NUMBER ?IC.AIOE NUMBER <br />MONITORING PERIOD <br />YEAR MO D Y YEAR NO DAY <br />FROM TO <br />Form Approved <br />OMB No 2040-0004 <br />MINOR <br />(SUBR JC) <br />F - FINAL <br />DISCHARGE TO COYOTE GUL( <br />NOTE: Read Ir>ltructlons before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION No. <br /> <br />EX FNEOUENCY <br />of SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT .. c <br />„ ,i REQUIREMENT M I N 11`1U;^ MAXIMUM <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT .. ., .. - ,. <br />- REQUIREMENT 30DA AVV DAILY MX r iONTF <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT . , i.- I, IN <br /> REQUIREMENT ?ODA AVv AILY MX M0i, <br /> SAMPLE <br /> MEASUREMENT <br />1 ( PERMIT .. _ L _. . <br /> REQUIREMENT i 1 I 30DA AVC- DAILY MX MONTH <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />s <br />I NST MAY. <br />_ i_ NT <br /> SAMPLE <br />i r MEASUREMENT <br /> PERMIT - „ <br /> REQUIREMENT CODA "ill- <br /> <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT :. t REFILVIT. . <br />REQUIREMENT DODA ; -,-NI LY t 1 ?, <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER I fenrly ° , penalty.( Ie" that this document and at nurhmenb were i TELEPHONE DATE <br />prepared under my direction or mper.tston In accordance with • system designed <br />to agars that quarried personnel properly ether and eyaW.le the information / <br />aubmltted. Bred on my Inquiry of the person or persons who manage the system <br />• <br />tl <br />n <br />lbie fo <br />i <br />I <br />ti <br />th <br />I <br />th <br />th <br />f <br />f <br />C/? ?? <br /> <br />r _.. <br />y respo <br />a <br />er <br />ng <br />orma <br />on, <br />or those persons direc <br />r ga <br />e <br />n <br />e <br />n <br />ormation <br />t <br />k <br />»rd <br />li <br />f <br />t <br />t <br />b <br />1 <br />d b <br />d <br />l <br />t <br />y <br />; - <br />es <br />o <br />my <br />ne <br />ge an <br />rue. accura <br />e, an <br />e <br />e <br />, <br />comp <br />e <br />e. <br />- submlltM ls. to tAe <br />SIGNATURE OF PRINCMAL EXECUTIVE <br />i <br />ifi <br />N <br />f <br />I <br />' <br />TYPED OR PRINTED car <br />gn <br />penslo" for submitting <br />alse <br />nformation, <br />1 am aware that there are s <br />Including the possibility of fine and Imprisonment for knowing ytol.tfora OFFICER OR AUTHORIZED AGENT CODE NUMfiER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference off attacnments hare/ <br />ABLE SOLIDS LIMIT APPLIED FOR 4=IOYR,24HR PRECIP EVENT- <br />:-DS MONITORING - I. B. 2. <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. ; •' ? Z `' ,' IJlte tS,a;4_-?>[t ?9nn. <br />---------------