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PERMITTEE NAMEIADDRESS (Include Facility Name/Location if Different) <br />NAME €= ;7 Pof e T.13ftgr-1';' COAL MINING <br />ti. <br />ADDRESS EON;' Iv.1h#r . <br />ENtia'I_ ` W 0f. D C 1-31 E01 12 <br />FACILITY F <br />?'•ii-A ` 1'l i I•d_ _ <br />LOCATION CO 00467 <br />AT'Tt;f } L!-y a iya ?? 1.---Nl41'! A?.NIC T1,,4EER <br />Form Approved. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) OMB No. 2040-0004 <br />DISCHARGE MONITORING REPORT (DMR) M I NOR <br />PERMIT NUMBER DISCHARGE NUMBER F - FINAL r OLIT I <br />L SCi'-IZ.w.' TO I-i1O.,_ D1 T C!°f#3/7(R}UT C ti <br />MONITORING PERIOD <br />YEAR MO__ DAY TO YEAR MQ.. DAY- <br />FROM (,<1C4 DISCHARGE . ('"`_ ` <br />NOTE: Read Instructions before completing this. form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR-CONCENTRATION NO. FREQUENCY SAMPLE <br /> <br />EX OF <br />TYPE <br /> • ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS - <br /> <br />`? 'r t - ?'I T ?.1, C., SAMPLE <br />Y.k.[`"' "e++' <br />1 T <br />y`, .K rf..?Y,. 'ir,.` <br />tf"'t'fi:'t?r" .#. <br />•)f"'IF.">i'IS"F? .fF <br /> <br />I <br /> <br />II L <br />" ME \ <br />V I SEAL, ASUREMENT <br /> PERMIT , <br />E FFL.tJF=•i'4! :P"+':t'-. VALUE REQUIREMENT ;N T i i. -NS` ._=0 <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT ,. <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT . <br /> REQUIREMENT <br /> SAMPLE J <br /> MEASUREMENT ' <br /> PERMIT <br /> REQUIREMENT <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of law that this document and all attachments were TELEPHONE DATE <br /> <br /> <br />v Prepared under my direcjion or supervision in accordance with a system designed <br />to assure that qualified personnel properly gather and evaluate the information <br />- <br /> <br />Y C..•e ??,? eC <br /> <br />J 100X , submitted. Based on my inquiry of the person or persons who manage the system, <br />or those persons directly responsible for gathering the information, the information <br />submitted is, to the best of my knowledge and belief, true, accurate, and complete. <br /> <br />r <br />i <br /> <br /> <br />IGNATURE OF PRINCIPAL EXECUTIVE . <br />rl?( 2r.y f //t # <br /> <br />,•G? >V jet ?.;7t <br />t O <br />t <br />f /, <br /> <br />10 <br />' <br /> <br />TYPED OR PRINTED mat <br />on, <br />I am aware that there a4ignificant penalties for submitting false info <br />including the possibility of fine and imprisonment for knowing violations. • <br />OFFICER OR AUTHORIZED AGENT <br />AREACODE <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference aH attachments nere) <br />•7-C z;' 'E' t::N i - SEA 1. A. 3, F'C. 4, FOR <br />SLJ__-`.D5 :EM T Wr L.L BE WAIVED FOR b*Z:'`?.?.4Hk P?--- <br />OiR RI_'f .?•NIP SIG '1NS#RUCTTDNS -- I. C. -10, P0. V. <br />EPA Form 3320-1 (Rev. 3/99) Previous. editions may be used. l•}??23r_1 ?CYII?IS 1S^3 ?}- t?>?OTril..' ?AGE