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NAME <br />ADDRESS t. 11. U r'ANYON MINE. <br />WEST 44i-++4 CTREET <br />r'`41DAD r,,? r7 a I C <br />FACILITY - NC; I TO CANYON I`. I NE <br />LOCATION 'ON ("o B i c <br />i?e;•.! i'r T'Fii it`"F'y-1{J. Lt{?!`(•ST <br />DISCHARGE MONITORING REPORT (DMR; 6 _ <br />PERMIT NUMBER DISCHARGE NUMBER - r jNA!_ L.AP <br />MONITORING PERIOD i yrjnl <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY <br />OF SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE -- <br /> MEASUREMENT <br /> PERMIT _ s o b. q <br />E F i i-'-ii i •l :;; REQUIREMENT <br />Cl _ I IiE SAMPLE <br />SUSP ENLt_ : MEASUREMENT <br />00530 PERMIT is s +rit# # ."- t it Irt+ "'•;-' I L t1 i t i <br />t REQUIREMENT <br /> SAMPLE ?. r I -' <br /> MEASUREMENT -- <br />- PERMIT ?<+,#+s## ##i¢?.;:. ± - <br />- , c tjFsL l i REQUIREMENT / <br /> SAMPLE / <br /> MEASUREMENT <br /> PERMIT <br />- <br />7" <br />F L'JEiJT ;c VA! __k REQUIREMENT <br />iJi;_ :tlul' SAMPLE t.c _r, ._. :.rrnF7 <br /> MEASUREMENT <br />r 1 _ <br />r PERMIT 1- r fi s_ Jf ` rc _ <br />F : ' <br />JEN F 'I:; 'Sr Vr?``%1 REQUIREMENT <br />i_ I "J ti C. it ?J I i OF? SAMPLE <br />T i TRE.ATP,E.NT PLAN i MEASUREMENT <br /> PERMIT #!i r. <br />t REQUIREMENT <br />SAMPLE 94 ) <br />MEASUREMENT <br />PERMIT ( F c rx .• t r:. .. , ^ . •._'Ai <br />REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I certify under penaby of law that this document and all attachments were <br />d <br />d <br />d <br />h <br />d <br />d TELEPHONE DATE <br />1 t er my <br />irt-ction .x supent>ion m accor <br />ance ccit <br />esigne <br />prepared un <br />a system <br />to assure dint yuahfted pcm)nnel pn,perly gather and esaluate the mtiotmation r <br /> <br />_ submitted. Rased on my myuin of the person or persons who manage the system, <br />or those pwmms directly responsible for gathenng the inlomnation. the information ?- <br />J <br />f <br /> submitted is, to the hest of my knowledge and belief, true, accurate, and complete. <br />I am aware that there are si <br />nificant <br />enalties for submittin <br />false intbrrttation SIGNATURE OF PRINCIPAL EXECUTIVE l•,? ' ! _ /? r J <br /> <br />TYPED OR PRINTED g <br />g <br />- <br />p <br />w <br />d <br />h <br />b <br />f ti <br />d i <br />i <br />l <br />ti <br />i <br />l <br />l <br />f <br />k OFFICER OR AUTHORIZED AGENT AREA <br />NUMBER <br />YEAR <br />MO <br />DAY <br /> ing t <br />ity o <br />ne an <br />mpnsnnment <br />or <br />no <br />ing v <br />o <br />a <br />ons. <br />nc <br />u <br />e possi <br />i CODE <br />GUMMr-N I.J Mlru r_Ar L#4NMf Ivly yr mv4T VIUL AI IUIYJ (RC[tlrCr[GC der dlldNlrrrCrltJ r1@r C/ <br />- IP c°!Fi'J" rLll,_tF,rT Tr, `?Uf?L)r?? SF Fpn`f. AF 'I!-'. IMF ?::y I^J <br />PAGE OF <br />EPA Form 3320-1 (Rev. 3!99) Previous editions may be used y -_ ibis is 8 4-Nn fOrnl.