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FFHMITTEE NAMiiE AD-=+LSS <br />NAME <br />4 <br />ADDRESS L.JftE`;? i TJ CAN MN MINE <br />3,,t WE'--7 MAIN STRT.ET <br />NIDAD O 8108= <br />FACILITY <br />ENG I . D CANYCIN MINE <br />LOCATION 3.TDW co 81091 <br />rl 11 -rul"IMM C= Mill <br />Eno F 1, T <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER T i I r (AF <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO >( <br />?JnTF• Ranri Inctrltrtinne hafnra r,mmnlatinn thlc fnrm <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREDUENCY SAMPLE <br /> <br />EX OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE I MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br />r_ PERMIT W1CE/ =hP,?; <br />3POSS AL{ ; REQUIREMENT <br /> SAMPLE t;J r <br />=>i?SP ENDED MEASUREMENT <br />. O L 0 PERMIT t ,aet# is i 45 WICEl Jft„ : <br />= FL-DENT RC': REQUIREMENT J =t',lG . LiH Zt_ t' iiG14 Ti <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT r!I'.:_.. <br />F'L._'Eh T GROSS V.,- :.• REQUIREMENT , •? ' r c :. It?NTF! <br />r L;I:.N I U>"i, SAMPLE <br />,D TENT IALLY DIE;-Iii 11, MEASUREMENT l <br />13c 1. C• Q PERMIT !aB <br />i-!-;FN r GI`'OSS VAL REQUIREMENT <br /> SAMPLE a..; . <br /> MEASUREMENT <br /> PERMIT -1- 4 # s 1 ?:s- aF#ik 1n i1i IT ji?1 :R !r' <br />r-r•I ;, REQUIREMENT ;ST "i'ti t. C:FfIT <br />?( r•i; SAMPLE t # ; <br /> MEASUREMENT <br /> PERMIT PEPnQT (?. - ter#w,a. > 1i.ir Yi?T) ?F <br />c rJT V REQUIREMENT <br />D SAMPLE <br /> MEASUREMENT <br /> PERMIT d. i it x-si <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I ccnifi under penalty of laa that this dosutnent and Al auachmcns were <br />d <br />d <br />d / TELEPHONE DATE <br />`. Prepare <br />un <br />er my <br />irection or suPen ision in acc,dance with a syacm drsi¢ned <br />if <br />d <br />h <br />l <br />h <br />d <br />l <br />h <br />f <br /> to assure t <br />at yual <br />) gat <br />uate, t <br />t d personne <br />grope <br />er an <br />csa <br />e in <br />ormation <br /> submitted fiaaest on ms mqutrr of the person or persons who manse the svstctn. <br />bl <br />h <br />d <br />h <br />` • <br />•? /' ? <br />? <br /> ose persons <br />ucstle re pow i <br />or t <br />e for gat <br />ering the information. the mforrnatian <br />b <br />b <br />f <br />k <br />M <br />li <br />i <br />d <br />h <br />d <br />d b <br />f <br />d - <br />- <br />{,? J i r <br /> tte <br />is, t.. t <br />et o <br />my <br />c <br />j an <br />e <br />true, accurate. an <br />su <br />m <br />e <br />n <br />e <br />complete. <br />m aware that th <br />re <br />re si <br />nificant <br />I <br />n <br />lti <br />s f <br />r s <br />b <br />itti <br />l <br />t <br />f <br />t SIGNATURE OF PRINCIPAL j(XECUTIVE <br /> <br />TYPED OR PRINTED g <br />a <br />e <br />a <br />pe <br />a <br />e <br />o <br />u <br />m <br />ng <br />a <br />se m <br />ion. <br />omta <br />!c3 udmg the possibdn} of tine and imprisonment for knowine violations OFFICER OR AUTHORIZED AGENT AREA <br />CODE NUMBER <br />YEAR <br />MO <br />DAY <br />vvnunu• r.r r...v r_nrarr?r?r rvr• yr e•u? r vrvr?r rvn.? Inererena.e on ouev.nnrenw nor e/ . <br />;'PECTP EVENT SUBJECT TO L!_'RDEN nF PR•^317F FE(?jlTr?FM!-?,j--c yNJ <br />- DIVISICIN <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used. T- Iis.is a 4-pail, firm. PAGE OF