Laserfiche WebLink
PERMITTEE NAME)ADDRESS(lwcir )rw*ty Naw?Lxafran(/D(fI t) <br />NAME <br />ADDRESS _ <br />BOX 400 <br />INIA CO 8142 <br />FACILITY 11 E NO r1 MINE <br />1OC'' NIA CO 8140 <br />LLIAM A. BEAR JP.. MINE MGR <br />NATIONAL POLLUTANT DISCHAROE ELIMINATION SYSTEbt (INPDE,S) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DA_ <br />FROM TO <br />Form Approved <br />OMB No. 2040-0000 <br />l M%Jorl <br />F - F <br />SR: DE <br />NOTE: Read Irntructlww befwe completMp this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREQUENCY SAMPLE <br /> OF <br /> EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />F'iE <br />S <br /> l <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT _ <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT :e a ###t? ##.. _ _ i / <br /> REQUIREMENT <br />MON TI1 <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ##31 #;; _ '_. '?? ' <br />1 REQUIREMENT 4 r'NTN <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT I ;AX <br />j SAMPLE ri- <br />i MEASUREMENT <br /> PERMIT Op -r <br />EP OR <br /> <br />t <br /> REQUIREMENT _ ; LY i' <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT E. J ! :-i U A <br /> REQUIREMENT <br /> <br />NAME/TiTLE PRINCIPAL EXECUTIVE OFFICER t natty . r penalty o a. that b H dorument and au attarhmend were <br />TELEPHONE <br />DATE <br /> prepared under my dlrerlbn oe mpe r.ldon In accordance wlth • system dead jned <br /> to am, that qualified personnel properly gather and evaluate the Information <br /> aabmltted. Board on my Inquiry o (the person or persons who manaie the system. - <br /> or Ihou persons directly mponl1w for lalberlrq the Information, the information <br /> subadlted h, to the beat of my tnonlecite and beNef. crier, aecurele. and complete. - <br />- I am aware that there are significant <br />enold" for eabrrdltln <br />fate Information SIGNATURE OF /RINCWAL EXECUTIVE <br />-- " <br /> p <br />g <br />. <br />I RE <br /> <br />TYPED OR PRINTED <br />nArMtnt the podblaly of floe and Imprisonment for knowing vldaUorn <br />OFFICER OR AUTHORIZED AGENT J <br />CODE NUMBER <br />YEAR <br />MO <br />DAY <br />I <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference >rJJ attachments hemp) <br />EPA Form 3320-1 (Rev 3/99) Previous editions may be used This IS a 4-Pail LOfRI. PAGE OF