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PERMITTEE NAME/ADDRESS (Inclade F"ility Name/Location if Different) <br />NAME MINING <br />ADDRESS ?:-? r, :4s s I ,( <br />FACILITY <br />LOCATION <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />M 1-NOR <br />(S11)BP <br />F IF <br />4i t "4' <br />Form Approved. <br />OMB No. 2040-0004 <br />i.- <br />L.S!Sfi-?%Ii=_J,%s <br />MONITORING PERIOD <br />YEAR 'MO_ DAY Y AR DAY # 7a Y: sp' -lAP GE I I <br />FROM la. s. To , <br />NOTE: Read Instructions before completing this form. <br />PAR <br />TER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREQUENCY <br />OF. SAMPLE <br />AME EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />l SAMPLE .r?s I.. aa,.. I 3f a :s : #E I' t3 1 I14 iN SIT-1 <br /> MEASUREMENT . <br /> <br />004( PERMIT it# 3 1 3f 3t'? # a ° _ r x <br />t <br />' <br />SU <br />1 3f7i?Tt i <br />EF i~L. U1, N'd I t 1_r'« REQUIREMENT f?I l`7la"t r ? <br />€ <br />1HX ? f7 <br />Wl * r .... <br /> <br />SAMPLE <br /> <br />» zi <br /> <br />a• z r • <br /> <br />a ..,_ <br />21 <br /> <br />C c? <br /> MEASUREMENT <br /> , <br /> <br />J <br />(U'; <br />PERMIT <br />3F#34# <br />..yt3.1} <br />"n <br /> <br />r G <br />3C <br />? <br />C <br /> <br />I1?{ }] AV <br /> <br />M(?'} <br /> <br />MONTH <br />.t.}l'. <br />EFFLUEN ,!'E,` .; l:tl REQUIREMENT ti l <br />9 <br />J <br />LL <br />DS, -,. ' '`FT( E <br />SAMPLE '»:.. ..f».••.Y ..f. "r°t'?f 'it"a?"'.' ,..k.b?. ..?'. ..`.w <br />L ©. 1 <br />L G .) :I. . <br />2/ <br />L p a i3 <br /> MEASUREMENT <br /> <br /> PERMIT st .z st # 3 1 #?4 ## i :1 - r # ., s R <br />EFFLt,tF.t?l? '; °1AL_t)I REQUIREMENT telE 300A f-IVCT DAILY N-A r'IL/L MONTH <br />{Ii:?4 SAMPLE r 9 r3i a x r st ii i` i> # x#'.; a <br />35 <br />50 c <br />/?I <br />- <br />: I "P L F MEASUREMENT <br />p <br />. <br />TOTAL R r <br />O{?E`t } {' "' PERMIT 3t?# #iP ?t :T;? :rxF?t 4#1?• <br />A <br />r• r t <br />_ <br />(D <br />` <br /> <br /> <br />M <br /> <br /> <br />r lL <br />` <br /> <br /> <br />ONTH <br />EFFLUEN • ;i .x` a YAL..U!` REQUIREMENT x ti #. 't?J <br />3iiQA • DAIL . <br />. <br />1.1AIgCriN'E-" L_: r SAMPLE it ?i - .p t : sf x ?i• .a;?._a. 44 c54 <br />d <br /> <br />QS <br />Z/ <br />3O <br /> <br />C` 5 <br />TS QLVL <br />D MEASUREMENT <br />. <br />_ 1 <br />01319 PERMIT <br />##DFstfF <br />#t##3F <br />si'f :r <br />fit . *'1 <br />r=- <br />EF?F"L UE.''?1 , VALUE REQUIREMENT 3vBH ??C? DAILY MX tiG!L MONTH <br />FLOW, I [ .a # s OR <br />SAMPLE <br />( :i <br />x fr A it r a <br />sr x s»ot x <br />tr .x tt sr a <br /> <br />1 <br />J 5?0?`i <br />:1•I"i` FN T FLAW <br />-RU TR MEASUREMENT 0,14-0 f <br />.. ( <br />TE <br />l3 Tt ir1 PERMIT 6 <br />'3R T <br />- <br /> <br />W <br /> <br />*## <br /> <br />.. <br />EFFi_UEN VAt..;U' REQUIREMENT 301:A r?iJG DAIL`f N X PG-D it# # <br />oil AF;D t SAMPLE =? 3h i si f A • st : t t 3r R -t tr sr a a <br />153LJAL MEASUREMENT <br />V <br />;r i #'li zt <br />r ?s t.; PERMIT # i E8 1 <br />e' R <br />2 tt 9r ? <br />I'1N? <br />EFz I_C}1=IVY Vitt UR. REQUIREMENT I1?6?T MAX k? 0=0 <br />INCIPAL EXECUTIVE OFFICER f certify under penalty -f law that this document and all attachments were TELEPHON E DATE <br />NAMEITITLE PR prepared under my direction or supervision in accordance with a system designed <br />U) I j to assure that qualified personnel properly gather and evaluate the information <br />t <br />th <br />h <br /> em, <br />o manage <br />e sys <br />submitted. Based on my inquiry of the person or persons w <br />ti <br />h <br />i <br />f <br />+ <br />j <br />^ <br />? <br />1 <br /> <br />`' orma <br />on - <br />e <br />n <br />or those persons directly responsible for gathering the information, t <br />submitted is, to the besfof my knowledge and belief, true, accurate, and complete. <br /> <br />SIGNATURE OF PR CIPAL EXECUTIVE ? v <br />? <br />V,3 [},may t <br />?? <br />\ <br />- j?j '*r I•iO ' / <br />S,,,J ! <br />{, 1 <br />x( <br />ri?? <br />v am aware that there are significant penalties for submitting false. information, AGENT <br />UTHORIZED <br /> <br />AREA <br /> <br />R <br />A <br />DAY <br />TYPED OR PRINTED including the possibility of fine and imprisonment for knowing violations. OFFICER OR A CODE NUMBE R <br />YE MO <br />.1 <br />i <br />COMMENTS AND EXPL.ANAI IUN Ul- A14T VIULAI IVrv0 (r VjV1W„t.C all auawunw,aa .. <br />S(:31..;s:i', 1 MIT WILL DE WATYED FOR :>1QYR.., 24HR PRF.:t, IP EVE'W - SEE I• A. 3, PG 4, 'FOR REQUIREMENTS. <br />R"IFtLY SA,tPI T.NG INSTRUCTIONS _ I C;,110, FI(3. 9. <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. 00230/CqWi?A 4+ Mrm,. PAGE 101= <br />w .. <br />?1 <br />4