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PERMITTEE NAME)ADDRESS(Y-d6&F.rWry)VO"?l-wrr°n((D(,ft-t) <br />NAME <br />ADDRESS <br />BOX 483 <br />NIA t7 8142E <br />FACILITY 'E NO. 2 MINE <br />LOCATION NIA CO 8142E <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM ((IVPOf$) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHAAGE NuMeEn <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />NOT <br />OMB No 2040-0004 <br />, <br />E- l_TA <br />E Form Approved <br />: Reed Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, <br /> <br />EX FREQUENCY <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT 1E't M <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />dd-nerM and all Hbthmenli were TELEPHONE <br />NAME/TiTLE PRINCIPAL EXECUTIVE OFFICER I "Filly " r Pr"a Iy ° aw that thh DATE <br />? <br />p"pared under my dirertlon or -pr lfill In ?ttWAanR with i SySIMI def4?11e'd <br />to aesu" that quaBfied personnel P qm y rather and eeahrate the Information <br />ereorss who mana <br />In <br />uir <br />of tin <br />erson or <br />e the s <br />stem <br />itt <br />d <br />d <br />n m <br />b <br />B <br />q <br />y <br />p <br />p <br />g <br />y <br />. <br />su <br />. <br />re <br />o <br />y <br />m <br />e <br />r <br />ibi <br />th <br />i <br />f <br />th <br />t <br />th <br />I <br />i <br />i <br />f <br />m <br />e <br />ar ga <br />ormatkrn <br />or those prrwm directly rnpo <br />er <br />ng <br />e <br />n <br />ormat <br />on. <br />e <br />n <br />f m <br />kn <br />whd <br />nd b <br />li <br />t <br />t <br />f <br />d <br />l <br />r <br />y <br />ge a <br />rue, aresl" <br />r, an <br />submitted h, to the b"t o <br />o <br />e <br />e <br />. <br />menp <br />e <br />e. <br />SIGNATURE OF PRINCNAL EXECUTM <br />fi <br />t <br />i <br />I <br /> caw <br />penairks for subm <br />tting fake <br />nformation, <br />I am aware that the" are dgN AREA <br /> <br />TYPED OR PRINTED <br />inchieling the possibility of fine and Imprisonmest for knowing eblatlorrs. <br />OFFICER OR AUTHORIZED AGENT NUMOER <br />CODE <br />J Y <br /> <br /> <br />EAR <br /> <br /> <br />O <br /> <br /> <br />AY <br />COMMENTS AND EXPLANATION Ur ArvT VIULAIIVM1 f/fortrancs irr macnnrarnta narwt <br />n aT? (iprr rr> -r T r'! TT- rI AT - APPRF",;FP RV >, O T-), <br />EPA Form 3320-1 (Rev 3199) Previous editions may be used This IS a S-pari form. PAGE OF