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rfRMITTEE NAME/ADDRESS(In.i.frf?rYryN?+?L«nnon(fDil") <br />NAME <br />ADDRESS 1E NO. 2 MINE <br />BOX 483 <br />NIA CO 8142 <br />FACILITY 1E NO. 2 MINE <br />LOCATION NIA CO 8142 <br />LLIAM A. BEAR JR., MINE MGR <br />NATIONAL ?OILUTANT OISCHAAOE ELIMINATION SYSTEM /NPOESI <br />DISCHARGE MONITORING REPORT (O R) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DA Y AR D Y <br />FROM TO <br />MI <br />Form Approved <br />OMB No 2040-0004 <br />I- - r t Ivnt_ ars..c_ t o <br />SR/MINE WTR TO DEER TRAIL DTCH <br />NOTE: Read instructions before completing this fwm. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO• FREOUE14CY <br />OF SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT L: . r . <br />..l f-- N REQUIREMENT M I N I MUN MAXIMUM <br />. SAMPLE <br />i=N MEASUREMENT <br />` •?'• <br /> <br />PERMIT <br /> <br />.. .. ,. <br /> <br />-? <br /> <br />. <br /> <br />. _.: <br />c <br />. . <br />is L q UZ' y r REQUIREMENT 3UDA A'•l1 . <br /> SAMPLE <br /> MEASUREMENT <br />0 <br /> <br />PERMIT FT r- r' u I <br />., <br /> <br />GROS`. <br />REQUIREMENT 30DA AVG DAILY MX <br /> SAMPLE <br />S F`.' MEASUREMENT <br />C PERMIT <br /> REQUIREMENT a ?j`J DA I L ` C iX MONTH <br /> <br />ft 1! <br />_ <br />SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />3F <br />IV <br /> REQUIREMENT 7'?ST MAX SENT <br /> SAMPLE <br />?. ' MEASUREMENT <br /> PERMIT <br />- REQUIREMENT 30DA AVG DAILY MX <br /> <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />=. REQUIREMENT NST MAX <br />NAMElTITLE PRINCIPAL EXECUTIVE OFFICER 1 "'lay ..6" pen' ly ° ow that thh dncumenl and alt ¦ItacM+rnts were TELEPHONE <br />prepared undte my direction oe fupenlflm In .ccordan" with .:)stem darned DATE <br />1o .alone that qualified personnel pro"Ay gather and c-luele the Information <br />fobmilted. Based on my Inquiry of the person or persms who manage the system, _ <br />the Information <br />she Information <br />dlrectl <br />m <br />onsible for <br />atherin <br />th <br />o <br />r <br />I <br />y <br />p <br />g <br />g <br />, <br />„ <br />ose pe <br />ns <br />at <br />s <br />sobmilled h, to the bet of my knowledge and belief, true, accurate. sod complete. <br />E OF PRINCNAL EXECUTIVE <br />IG <br />A <br />'`' <br /> 1 am swam that then arc slgnlfkaw pensitla for wbmltting false Information, S <br />N <br />TUR A AEA <br />E <br />ER <br />Y <br />O <br />TYPED OR PRINTED Inc Ing the possibility of fine and Imprisonment for knowing violations. OFFICER OR AUTHORIZED AGENT I <br />CODE NUM EAR M DAY <br />COMMENTS AND EXPLANATION OF ANY NIULA I IUN5 Iffsssrsncs an srrscnmainra nsrq <br />-:HR PRFCIP EVENT IS CLAIMED. IF CLAIM APPROVED BY WGCD, <br />S r T. A. 3, t7 , <br />13 T Fi 5; <br />This is a 4-part form. PAGE OF <br />EPA Form 3320-1 (Rev. 3/99) Previous editions maybe used. -