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PARAMETER <br />(32 -37) <br />(3 coed Only) r QUANTITY OR LOADING <br />` (46.131 (34 -61) <br />( Card Only) QUALITY OR CONCENTRATION <br />(38.43) (46 -53) (54 -61) <br />NO. <br />EX <br />FREQUENCY <br />OF <br />ANALYSIS <br />SAMPLE <br />(69-70) <br />AVERAGE <br />- MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS <br />H - <br />0400 1 0 0 <br />FFLUENT GROSS VALUE <br />SAMPLE <br />MEASUREMENT <br /># *^*' **Y <br />YY.1Y ** <br />it <br />* * <br />#it <br />St St <br /># #Y * #Y <br />e t <br />PERMIT <br />REQUIREMENT <br />** ## <br /># # # # ## # <br />6.5 <br />MINIMUM <br />INUN <br />* * *** <br />9.0 ' <br />flAYINU" <br />ONCE/ <br />GRAB <br />MONTH <br />IDS, SETTLEABLE <br />V .145 1 0 0 <br />FFLUENT GROSS VALUE <br />SAMPLE <br />MEASUREMENT <br /># #t # ## <br />°' <br />YY *M'YY <br /># ## <br /># # *# <br />#4 # # *# <br />y <br /># # # * *Y <br />Mx.JL <br />' PERMIT - <br />REQUIREMENT ' <br />" # ## ###' <br />■ " <br /># #IR # ## # <br />' _. * * * * ** <br /># # ##** <br />0.5 <br />DAILZ ,u. <br />ONCE/ <br />.GRAB <br />MONTH <br />IL AND GREASE <br />REON EYTR -GRAY [SETH <br />0556 1 0 0 <br />FFLUENT GROSS VALUE, <br />SAMPLE 1 <br />MEASUREMENT' <br /># # # # ## <br /># # #Y ## <br />### <br />v # # #' <br /># # # # ## <br />## # # ## <br />rc <br />CONTINGRAB <br />GRIN <br />' - # # ##S# <br />' ### # ## <br />10 • <br />INST MT <br />PERMIT "' <br />REQUIREMENT <br />, #,'R # # ## <br /># # # # ## # <br />FLOW,` IN CONDUIT OR <br />HAD TREATMENT PLANT <br />0050 1 0 0 <br />EFFLUENT GROSS YALU& <br />SAMPLE <br />MEASUREMENT <br />�© 5 [ <br />�(�r <br />R <br />DAILY HT <br />NGD <br /># #v### <br /># # # #�.`. <br />YY 1 <br />it <br />it * <br />it it <br />it * <br />N <br />I <br /># # # ###' <br />'. ### # ## <br /># # # #* <br />. MEEELZ_1STAI <br />PERMIT - <br />REQUIREMENT <br />- .REPORT <br />301: AY <br />.OLIDS, TOTAL" <br />I I S SO LV E D <br />0295 1 0 0 <br />FFFLUENT S, ROSS VALUE <br />SAMPLE <br />MEASUREMENT <br />' # # # # ## <br /># # #$ ## <br /># ## <br /># # ## <br /># # # # ## <br /># # # # ## <br />nG /t. <br />- QTRLZ <br />GRAB <br />; # ### # #' <br />; # # # # ## <br />REPORT <br />DAILY I!Y <br />'PERMIT'' <br />REQUIREMENT <br />",' # # # * # #' <br /># # # # ## # <br />• IL AND GREASE <br />t UAL <br />.66 1 0 0 <br />EFFLUENT GROSS VALUE <br />SAMPLE <br />MEASUREMENT <br /># # # #Y# <br />' <br />ES =1 <br />NO =O <br /># # # # ## <br /># ### ## <br /># # # # ## <br />it it <br />it # <br />: # # # ### <br />, ###### <br /># # # # ## 4 <br />ONCE/;VISUAL <br />MONTH <br />PERMIT <br />REQUIREMENT <br />- ; * # # # ## <br />" <br />0 ' I <br />INST MY <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />- - <br />NAME/TITLE PRINC EXECUTIVE OFFICER <br />IA CEIF UND PNA OF L THA HAVE PERSONALLY EXAMIN ED <br />ND A F AMILIAR ER WI THE LTY INFORMATION SUBMITT HE AND BAS <br />ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br />OBTAINING THE INFORMATION I BELIEVE THE SUBMITTED INFORMATION <br />IS TRUE, ACCURATE AND COMPLETE I AM AWARE THAT THERE ARE SIG- <br />NIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING <br />THE POSSIBILITY 9F FINE AND IMPRISONMENT. SEE 18 U.S C. I 1001 AND <br />' 33 U.S C. ( 119 (Penalties under these statutes may include fines up to S/0,000 <br />and or maximum l enprisonmentof between 6 months and 5 years .) <br />a <br />Al, , ,e , yL� <br />� <br />TELEPHONE <br />DATE <br />//,^� <br />G�1 <br />7 �j 5.25 <br />) <br />�/ <br />01 <br />4-.)g <br />r � Tr _ r _, <br />IJ <br />M ` .) <br />� � J st , am Me rl .�ea Ie-5 <br />'`��1IiY lea, <br />SIGNATURE OF PRINCIPAL ECUTIVE <br />OFFICER OR AUTHORIZED AGENT <br />AREA <br />GOOF <br />NUMBER <br />YEAR <br />MO <br />DAY <br />' ' TYPED ORPRINTEP " "' <br />1 acdity Name / Loco' !event) ' <br />'NAME - PE Y COAL CO (!UCLA puN- fl <br />_ ELICIAL. <br />FACILITY r -- - - - -- — ^ -- <br />ATTN: DENNIS STEVENSON, PRESIDENT' <br />EPA Form 3320-1 (Rev. 9-88) Previous editions maybe used. <br />NATIONAL POLLUTAN r DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCH, ONITORING REPORT <br />(2- (17 -19) <br />PERMIT NUMBER <br />YEAR <br />FROM uu <br />MONITORING PERIOD <br />MO <br />DAY <br />Ul <br />(20 -21) (22 -23) (24 -25) <br />TO <br />(REPLACES EPA FORM T -40 WHICH MAY NOT BE USED.) <br />005 A <br />DISCHARGE NUMBER <br />YEAR <br />9U <br />MO <br />12 <br />(26 -27) (28 -29) (30-31) <br />F - FINAL <br />STORMWATER DISCHARGE <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />IF NO DISCHARGE OCCURS REPORT "NO DISCHARGE". OIL AND GREASE; SEE FOOTNOTE F/. <br />Approved. <br />No. 2040-0004 <br />oval expires 8-30-91 <br />DAY <br />it MINOR (SUBR WC) MITES <br />3031 NOTE: Read instructions before completing this form. <br />00104 /900810 -1402 <br />PAGE 1 OF <br />