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L4 <br />NAME F - FINAL ROUTT <br />TWENTYMILE COAL COMPANY POND DISCHARGE TO FISH CRK <br />ADDRESS FISH CREEK TIPPLE 000042161 MON 1 ® Check here if No Discharge <br />29515 ROUTT COUNTY ROAD # 27 PERMIT NUMBER DISCHARGE NUMBER NOTE: Read Instructions before completing this form <br />FACILITY LOCATION OAK CREEK, CO 80467 <br />FISH CREEK TIPPLE <br />-"' -"-"' " <br />ATTN: OAK CREEK CO 80467 <br />YEAR <br />MO MONITO RING PE RIOD <br /> <br />ATTN: JERRY N <br />NETTLETON <br />ENV SUPVS DAY YEAR MO DAY <br />. <br />, 08 04 01 TO 08 06 30 <br /> <br /> QUALITY O R LOADING <br /> QUALI TY OR CONCENTRATI ON FREQUENCY SAMPLE <br />PARAMETER <br /> <br /> <br />ARSENIC AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS NO <br />EX. <br />ANALYSISOF TYPE <br />, TOTAL SAMPLE *«**** ****** **...* <br />(AS AS) MEASUREMENT 2.0 2 <br />0 (28) 0 3/92 <br /> <br />01002 1 0 0 <br />PERMIT <br />****** <br />•**••• <br />•*••** <br />***:„ . GRAB <br /> <br />EFFLUENT GROSS VALUE <br />REQUIREMENT REPORT REPORT <br />' ONCE/ <br /> <br />ZINC, POTENTIALLY <br />SAMPLE ****** <br />***«** <br />****** 30DA AVG DAILY MX UG/L PER MONTH GRAB <br />DISSOLVED MEASUREMENT < 10 <10 (28) 0 3/92 GRA <br /> <br />01303 1 0 0 <br />PERMIT <br />«* <br />****** <br />**"*** B <br /> <br />EFFLUENT GROSS VALUE <br />REQUIREMENT REPORT REPORT ONCE! <br /> <br />SILVER, POTENTIALLY <br />SAMPLE ****** <br />*«**** <br />*«*... 30DA AVG DAILY MX UG/L PER MONTH GRAB <br />DISSOLVED MEASUREMENT <br />< 0.1 <br />1 <br />< 0 <br />(28) <br />0 <br />6/92 <br />G <br /> <br />01304 1 0 0 <br />PERMIT <br />"*'**' <br />-- <br />"'**** <br />***"•* . RAB <br /> <br />EFFLUENT GROSS VALUE <br />REQUIREMENT REPORT REPORT ONCE/ <br /> <br />COPPER, POTENTIALLY <br />SAMPLE ****** <br />****** <br />.***.* 300A AVG DAILY MX UG/L PER MONTH GRAB <br />DISSOLVED MEASUREMENT 7.0 7 <br />0 (28) 0 6/92 GRA <br /> <br />01306 1 0 0 <br />PERMIT <br />***** <br />****** <br />****** <br />**** * . B <br /> <br /> <br />EFFLUENT GROSS VALUE <br /> <br />REQUIREMENT REPORT REPORT <br />ONCE! <br /> <br />CADMIUM <br />SAMPLE ******«* <br />********* <br />***«*.**. 30DA AVG DAILY MX UG/L PER MONTH GRAB <br /> <br />POTENTIALLY DISSOLVD <br />MEASUREMENT <br />< 0.2 <br />< 0 <br />2 28 <br />0 <br />6/92 <br />GRAB <br />01313 1 0 0 PERMIT <br />******* <br />"**** <br />***«** <br />********* . <br /> <br />EFFLUENT GROSS <br />VALUE <br />RE EN <br />' REPORT REPORT , ONCER/ <br />CHROMIUM <br />TRIVALENT, <br />«*«*** <br />SAMPLE <br />****** <br />****** 30 DA AVG - DAILY MX UG/L PER MONTH GRAB <br />POTENTIALLY DISSOLVD MEASUREMENT < 20 < 20 (28) 0 2192 <br /> <br />01314 1 0 0 <br />PERMIT <br />'«*** <br />"**'?? <br />**'*** <br />*••*** GRAB <br /> <br />EFFLUENT GROSS VALUE <br />REQUIREMENT REPORT REPORT <br />ONCE/ <br />LEAD, SAMPLE <br />****** <br />****** <br />**««+* 300A AVG' DAILY MX . UG/L MONTH GRAB'' <br />POTENTIALLY DISSOLVD MEASUREMENT < 0.26 0 <br />3 (28) 0 3/92 <br /> <br />01318 1 0 0 <br />PERMIT <br />****** <br />*'**** <br />«***** <br />* <br />*** . GRAB <br /> <br />EFFLUENT GROSS VALUE <br />REQUIREMENT REPORT <br />REPORT <br />ONCE/ <br /> <br />NAMEITITLE PRINCIPAL EXECUTIVE <br />OFFICER <br />I Certify under penalty of <br />law that this document an <br />d all attachmen <br />ts were <br />re <br />d <br />d 30DA AVG DAILY MX UG/L MONTH GRAB <br /> <br />my direction or su <br />ervisi <br />on in <br />co <br />d <br />ith p <br />pare <br />un <br />er / TEL EPHO NE DATE <br /> <br />B <br />i p <br />ac <br />r <br />ance w <br />a system designed to assure that qualified <br />r <br />an A. Watterson, P.G. <br />Geolo <br />ist personnel properly gather and evaluate the information submitted. Based on my inquiry of 970 870 - 2750 ( ?r ` <br />r <br />g the person or persons who manage the system, or those persons directly responsible for <br />gathering the information <br />the informati <br />b <br />itt <br />d i SIGNATURE OF PRINCIPAL i ( ! <br />fi <br />iJ <br /> , <br />on su <br />m <br />e <br />s, to the best of my knowledge and belief, <br />true <br />accu <br />t <br />d OFFICER OR AUTHOR ZED AGENT AREA CODE NUMBER YEAR MO DAY <br /> , <br />ra <br />e, an <br />complete. I am aware that there are significant penalties for submitting <br />TYPE OR PRINTED false information, including the possibility of fine and imprisonment for knowing violations. - Cj---"-"? <br />?.vwnvrc?? 1 J *VVU CAPLANA i ION OF ANY VIOLATIONS (Heference all attachments here) <br />-p ,-? <br />1-i It e, 6 -Iz? <br />INFLUENT SAMPLES MUST BE COLLECTED 8 ANALYZED MONTHLY AND REPORTED QUARTERLY REGARDLESS OF WHETHER AN EFFLUENT DISCHARGE OCCURS. HYDRAULIC CAPACITY= 0.015 MGD; <br />ORGANIC CAPACITY = 31.2 LBS BOD-5/DAY. <br />EPA Form 3320-1 (REV 3199) Previous editions may be used <br />PAGE 1 OF 2 <br />00397/010709-1126