Laserfiche WebLink
Y LrIMII ItL I--- NATIONAL POLLUTANT DIS RGE ELIMINATION SYSTEM for ed <br /> Paciltn AamrlL—at, d erent) DISCHARGE M )RING REPORT IUAIR) OM LO.0004 <br /> '7` (l7-19) Appro pores 9-30-85 <br /> NAME; <br /> � .__-----.----- is-/M1I <br /> ADDRSS i <br /> E ?DU o - Yaie ------------ L�C%: /-Z <br /> --- rtagstaff, Ari zona 86601------- PERMIT NUMBER DISCHARGE NUMBER <br /> —————————— <br /> —————————————— MONITORING PERIOD <br /> FACILITY— Nuc 1 a Mi ne --_ YEAR MO DAY YEAR I MO DAY <br /> LOCATION -------------------- FROM 87 0� 0gq1 TO 87 j <br /> (20-21) (22-23) (24-23) (16 27) (28-291 (30-31) NOTE: Read instructions before completing this form. <br /> (3 Card Only) QUANTITY OR LOADING (4 Card Only) QUALITY OR CONCENTRATION <br /> FREO <br /> PARAMETER (46-33) (34.61) (38-43) (46-33) (3I-61) NO. OFV ENS SAMPLE <br /> (j137) EX TYPE <br /> I AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 61 I ANALYSI S(61.68) (69-70) <br /> SAMPLE <br /> MEASUREMENT No Discharge <br /> PERMIT <br /> 55 05-C/ REQUIREMENT <br /> Tcs V SAMPLE <br /> MEASUREMENT <br /> O PERMIT REQUIREMENT <br /> �- <br /> rJ/ IV SAMPLE <br /> �/ MEASUREMENT <br /> PERMIT - <br /> �yJS REQUIREMENT <br /> 6& r • 501-46-S SAMPLE <br /> MEASUREMENT <br /> U <br /> PERMIT <br /> /v�A RHOLIER£MENT- <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> 7 � �.� RECUIRH.M ENT <br /> LIB 1/ SAMPLE <br /> MEASUREMENT <br /> PERM IT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> l PERMET ' <br /> 5(/17 RffJ?U tREM ENT <br /> NAMEMTLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED TELEPHONE D A T E <br /> AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN ANO BASED <br /> ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR - <br /> OBTAINING THE INFORMATION I BELIEVE 7HE SUBMITTED INFORMATION A�.t��� <br /> James S. Lunan IS TRUE ACCURATE AND COMPLETE I AM AWARE THAT THERE ARE SIG G I I <br /> 9 NIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION INCLUDING 1 602 774-5253 87 10 21 Manager'. Permits THE POSSIBILITY OF FINE AND IMPRISONMENT SEE USC S IDOI AN SIGNATURE OF PRINCIPAL EXECUTIVE <br /> 33 USC S 1319 -Permit", arlar. rhrwr �raraL. nwY mNadr Imr• ap r„ Ilur <br /> TYPED OR PRINTED and.rr marrmum rmPr1•,n1^I.nr„/hrlawn h nn,n lA.anA•.rn r.• OFFICER OR AUTHORIZED AGENT A EA NUMBER YEAR MO DAY <br /> OMMENT AND EXPLANATION OF ANY VIOLATIONS (Re/erencr all atlacrtments here) <br /> 0, Form 3320-1 (Rer. 10-79)PREVIOUS EDIT I SUPPLY ISON TO BE EXHAUSTED D (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.I } PAGE OF <br />