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PERMITTEE NAME/ADDRESS (Include Facility Name/Location ifDii ferenr)
<br />NAME
<br />ADDRESS CARDIDN JUNCTIC9,11 MUiNI
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<br />wIt.,Hi'rA FALLS •Y,' ;%:a*30,11
<br />FACILITY i' MINE.,
<br />. i.JSV??•1.%'rt•.w LOCATION P4{'PftaLJ { a .7. 30
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<br />T .T M 3 V:6.Rc rbt i2°F'.
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
<br />DISCHARGE MONITORING REPORT (DMR)
<br />PERMIT. NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM t.y', tw t ,?.L TO , ,
<br />Form Approved.
<br />M I NOR OMB No. 2040-0004
<br />( c'1 'Tt'' +.r, )
<br />7.. R GB
<br />F• FINAL
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<br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQ
<br />UF NCY SAMP
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<br />
<br />AVERAGE
<br />MAXIMUM
<br />UNITS
<br />MINIMUM
<br />AVERAGE
<br />MAXIMUM
<br />UNITS EX ANALYSIS
<br />F, I-} SAMPLE -^ #:gq#•gs #s: :• n-#.x; rs 1. 12)
<br /> MEASUREMENT
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<br />x:_FFLIJF-f Tt %f?t35Sr VALU: REQUIREMENT MiNiMLI i-is,Tf %P4 MONTH
<br />ONMONTH
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<br />SAMPLE
<br />SUSPEND D MEASUREMENT
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<br />EFFL.UEN_r RC-15S VALUE REQUIREMENT 30iriat AV T' " .
<br /> SAMPLE r ## # -.F. -n:.
<br /> MEASUREMENT
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<br />EFFLUENT GROSS VALU REQUIREMENT 1x 4• ?# ,?=vIG JA 3' ,v` MIt; ML. /L MONTH
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<br /> MEASUREMENT
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<br />1-i 5.'O?i'?i'%J1 i Sri'? SAMPLE 4 i1 .t x :.I i r,'#
<br />-!'i-RL; TREATMENT FLAN; MEASUREMENT
<br />szL•''.?:tii .1 Q t1 PERMIT REt"'-LO.1'Y°,,T REFOR #3i Ei si t? tikisii£ ##?#fik a.rx :L?i*J3'IN? KS:.OHD
<br />=FF LUEN T GFOS i VALU; REQUIREMENT 30I?A e+;1 DAILY i•i74 iS# 3{35
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<br />DISSOLVED MEASUREMENT
<br /> PERMIT ii k k EE €E # k 4i# ##? iiibs£ i4:SFeO.-tR REFORT TR(...tf :RY• B
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<br />-011L 44DD w { -:. ?s •... SAMPLE 9 n K# # r. K
<br />VI E.,UAL MEASUREMENT
<br />84066 .% ... ') PERMIT
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I fy under penalty of law that this document and all attachments were
<br />i T ELEPHON E DA TE
<br />1 „ e ^ prepared under my d
<br />rection or supervision in accordance with a system designed
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<br />to assure that qualified personnel properly gather and evaluate the information
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<br />rectly responsible for gathering the information, the information
<br />?i J 4 r submitted is, to the best of my knowledge and belief, true, accurate, and complete. SI NATURE OF PRINCI AL EXECUTIVE
<br />910
<br />1 &-141W11/1
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<br />A
<br />' I am
<br />aware that there are significant cant penalties for submitting false information,
<br />
<br />TYPED OR PRINTED
<br />L including the possibility of fine and imprisonment for knowing violations. OFFICER OR AUTHO [ZED AGENT
<br />A
<br />REA
<br />NUMBER
<br />YEAR
<br />M-
<br />DAY
<br />COMMFNTC ANI1 FYPI ANATIAN AF AIJV VIAL ATIAAIC CO
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<br />µ-.rTf.._ _ • GZR? _ .::"ta3i ''atY#?: '..F#``i' i }PIS''{ltd°_I} FOR pt? A7 ?lI"[L'j J...
<br />i c??} YrJ CLlr EVENT, 1L _StL'?Y t:'..la_C6r rt t? t i t ! y ROF' r_ e•z ri ? e
<br />R '!`?RJ ii!. f-__ 1'.._i . ?: OF PRE ?s_t*?v.isi-Y t^?'??f,aF•`4
<br />EJAIRT' I. r,. ANY ADDI'. 1ON?-?I.... :D re?'? ?'t-'Ir ?Li_ >-:mi?."?.L_i.?'.'z.? TO -iHi L?I''.l?.''.i??..)I`'•i i:ilT?'"IIir' gtrrG'; t 1Ka
<br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. 004 ._t,._ I? i-S HH. PAGE
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