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PERMITTEE NAME/ADDRESS (ley Forwry X?r?laerrarr (JDIQiw.m) <br />NAME <br />ADDRESS <br />BOX 483 <br />';VIA CO <br />FACILITY .1E NO. 2 MINE <br />LOCATION • N I A C U <br />'I1 TAM A AFAR AR . MTNF <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM /INPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER [TS71110E NUMeM <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />E3 FROM TO <br />M(-.z <br />Form Approved <br />OMB No. 2040.0004 <br />MINOR <br />iSUBR MH) <br />F - FINAL DELTA <br />DSCGH OF SR TO GUNNISON RIVER <br />NOTE: Read kntructlons before complotlnp this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br /> <br />EX FREOUENCY <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT tt ? #uT? ## ## . S :.i?#### 9.0 LY N"D <br /> REQUIREMENT MI N I I'i. !I' MAXIMUM <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT # tfit #u n k?r;. I, af?-# r t ; 35 70 <br /> REQUIREMENT SODA fi,'.%t3 V'; -ILY MX i 1Lli': ' I <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ?+#1itE#IF ^#SF ;»: REPORT REPORT "RAB <br /> REQUIREMENT :30DA t 'AILY MX `I <br /> SAMPLE <br /> MEASUREMENT <br /> ~ <br /> PERMIT .. -, .. -.. - .- ..3000 03000 ..f Ei f <br />rt?li <br />CIF REQUIREMENT 30DA AV V DA I'L 'r P1 X MONI'H <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT i°iAX <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT r uI, ClF,: q2 PO 7 it s` ;, s h At <br /> REQUIREMENT ;-, - r'+ILY HX _ <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT ,>?c##tt rFttllhs>? REPUR!" REPORT <br />:< <br />REQUIREMENT vRTR A., _ rARTR MAXI <br />NAMElTITLE PRINCIPAL EXECUTNE OFFICER I centlv er no ty o taw that Ihh document and an attachments were TELEPHONE DATE <br />prepared under my direction or wpervislon In accordance with a system designed <br />In assure thN qualm d personnel property ga1Mr and evaluate the Information <br />wbmltled. based on my Inquiry of the person w penom who manage the system, <br />di <br />tl <br />e <br />r <br />dbk f <br />th <br />in <br />al <br />th <br />I <br />ti <br />th <br />I <br />f <br />f <br />- <br />rec <br />y r <br />spo <br />s <br />er <br />g <br />e <br />n <br />orm <br />oft, <br />e <br />n <br />orma <br />on <br />or those persom <br />or ga <br />? <br />( - <br />no- to and belief, true. sceunle. and cpmpkle. <br />wbmllled h, to the best 0 <br />-y <br />SIGNATURE OF F'RINCMAL EXECUTIVE <br /> 1 am aware that there an signllleant Penalties for submitting f for Information. A A <br />TYPED OR PRINTED Inch ding the poarbtilry of rem and Imprisonment for knowing elolaltem OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reforenc• attachments here) <br />='R PRECIP EVENT IS CLAIMED IF CL-ATM APPPOVFD PY WGIrD, <br />AS(jREMENTS <br />EPA Form 3320.1 (Rev. 3199) Previous editions may be used. T)VS As A 4-pact- form. PAGE OF