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<br />NAME/TITLE PRINCIPAL EXECUTIVEOFFICER:'
<br />,,1- CERTIFY-UNDER PENALMOF LAW THAT I HAVE PERSONALLY EXAMINED
<br />'AND-AM FAMIUAR WITH THE INFORMATION SUBMITTED HEREIN; AND BASED
<br />ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR
<br />OBTAINING THE INFORMATION. L BELIEVE THE SUBMITTED INFORMATION
<br />7,IS TRUE, AtCURATE AND COMPLETE_ I AM AWARE THAT THERE ARE SIG- '
<br />„NIFICANT ,PENALTIES FOR ^SUBMITTING FALSE INFORMATION, INCLUDING
<br />-THE POSSIBILITy OF FINE AND IMPRISONMENT. SEE 18 U.S.C. II 1001 AND
<br />'33 U.S.O. ti 1319. (Penalties under these statutes may include fines' up' to 510,000
<br />and or maximum imprisonment of between 6 montlu and 5 years.)
<br />...
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<br />L TELEPHONE
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<br />TYPED OR PRINTED . .
<br />OFFICER OR AUTHORIZED AGENT
<br />AREA CODE
<br />- NUMBER -
<br />,
<br />'.YEAR
<br />MO I
<br />DAY
<br />Facility Nanse/Loo etent)
<br />NAME i) L i COAL CO eLOCLA
<br />ADDRESS COUNTY ROAD AA
<br />••■•• ••■• Ilmsamo mod... CO3000213
<br />_____ _ NtiCI.4.:j _,1 _c_0 2 Er c'
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<br />LOCATION—. —. ...-. — —.• — .—:,......,- .. OM. ati . Owl■ ...”7
<br />C e It -' -
<br />—.....- ..— —.. ..... —. -.1-- ....... " FROM
<br />- ,
<br />ATTN: DE NN USESTEV ENON, PRESIDENt - - ,... r: 7; 7 ao-zo
<br />NATIONAL POLLUT CHARGE ELIMINATION SYSTEM (NPDES)
<br />DISC a7-
<br />ONITORING REPORT (DMR)
<br />PERMIT NUMBER
<br />- I It
<br />MONITORING PERIOD
<br />002 A
<br />DISCHARGE NUMBER
<br />CJ6
<br />MO DAY 7 .- -YEAR MO
<br />(22-23) (24-25) - 0 ':(26-27) (28-29)
<br />DAY
<br />(30-31)
<br />Approved.
<br />F - FINAL No. 2040-0004
<br />STORMUAT RGE Approval expires 8-30-91
<br />ER DISCHA
<br />t 0 11 ( U WEr - -1 4. 1 4:r S
<br />NOTE: Read Ir before completing this form.
<br />COM MEN ANDEXNANATION OF ANY-VIOLATIONS (Reference all attachments here)
<br />IF NeDIS`tkARtE OCCURS REPO'RT"No7DISCHARCE". OIL AND GREASE; SEE FOOTNOTE F/.
<br />EPA Form 3320.1 (Rev. 9 Previous editions may be used.
<br />•
<br />(REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.)
<br />00055/900810-1402
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