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NATIONAL. POLL UTANT -'- -'NAPGE ELIMINATION SYSTEM <br /> DISCHARGE TORING REPORT <br /> (` +NO. IM-ROO73 <br /> r t• ?17-CT GOAL (PREP PLANT 1 <br /> PO box 158 <br /> CARBt '4[)AL F INSTRUCTIONS <br /> L CO 816,3 1. Provide dates for period covered by this report in spaces marked"REPORTING PERIOD". <br /> 2. Enter reported minimum, average and maximum values under"QUANTITY"and"CONCENTRATION" <br /> 12-3) to-,a U7.101 in the units specified for each parameter as appropriate. Do not enter values in boxes containing <br /> --- - asterisk3. "AVERAGE" is average computed over actual Ume discharge is operating. "MAXIMUM" <br /> ar.d"MINIMUM" are extreme values obse,ved during the reporting period. <br /> C r- 121 1 3. Spec,ty the number of analyzed samples that exceed the maximum(and/or minimum as appropriate) <br /> I' <br /> ST PERMIT NUMBER D15 SIC LATITUDE LONGITUDE permit conditions in the columns labeled"No. Ex." If none, enter"O". <br /> -- _..---_-_ -_ 4. :;{.eci iy frequency of analyais for each parameter as No. analyses/No. days. (e g, "3/7"is equlve- <br /> (W-21) 122-231 124-201 426-271 428.291 t30-311 lent to 3 analyses performed every 7 days.) If continuous enter"CONT." <br /> 5. Specify sample type("grab"or"_.hr. cornposita")as applicable. If frequency was continuous, <br /> enter "NA". <br /> REPORTING PERIOD: FROM 1 1 TO 79 14 ( 1 6. Appropriate signature Is required on bottom of this form. <br /> 7. Remove carbon and,etrin copy fur your:ecords. <br /> YEAR MO— DAY YEAR MO GAY S. Fold along dotted lines, staple and mail Ongu,al to office specified in permit. <br /> 1 31-371 _ <br /> (6.,081 lea-701 <br /> 1 (3 card only) y --QUANTITY CONCE(I wrd onty) - - ---^ - <br /> NTRATION FREQUENCY <br /> PARAMETER 130-6e1 1a6-63�_ 166�61 167•ea,196.66, OF 1.6.63+ l6:-c�l_ 162-Oil SAMPLE <br /> MINIMUM AVERAGE 'MAXIMUM UNITS .- NO. MINIMUM AVERAGE MAXIMUM UNI YS NO, TYPE <br /> EX EX ANALYSIS <br /> rLON IN CONDUIT REPORTED <br /> PERMIT �'IGG 11GD <br /> 7'i„5;- CONDITION— # # µ { \ —w #—{► -- - p ,} # # {} t* {} # # # # - 7/7 IN <br /> ±Mr,Sr TOT,,L OISS REPORTED {} {i {} {} {► {t # {} # {} {} <br /> (DIES, LVE!)) PERMIT — — V/ �Y ---- - MG/L -- - Gk — <br /> 7)3, CONDITION # r It # # # # # # It # # # {► # # # # # # # <br /> ToTGL SUSP REPORTED <br /> KG/DA -- MG/L - — — <br /> PERMIT CO'3'. CONDITION # # t� # } {} {: # {l' {: {'. # 3-1 1/7 G <br /> Of i,T OTA!_(QS Ft) REPORTED {} # q # {} # # ► # s) -- -- -- — ---- j <br /> - f <br /> PERMIT _-_ i15,.4DflY ---__-� _ ___- 11GIL <br /> r^ CONDITION /�fjl"�1''�- • 61. / Co <br /> PH�FTI'Lfl REPORTED <br /> PERMIT aU — ----- SU <br /> 114,"u CONDITION k ° # * * .# {} # # +► i # # # 9.0 Jll 1/7 6R <br /> OIL F ORE-ASEvVISWL REPORTED <br /> PERMIT <br /> A0',) 2 CONDITION it # 10 1/7 VI <br /> REPORTED <br /> P LRMIT <br /> CONDITION - <br /> REPORTED <br /> P E NMI T _�— <br /> CONDITION <br /> NAME OF PRINCIPAL EXECUTIVE OFFICER TITLE OF THE OFFICETI DATE t <br /> n I certify that I am familiar with the information contain ad In this <br /> N r 7 es I1)EN T- 7 ci L/ 3 report and that to the best of my knowledge and ballet eurh inforV(.--�- <br /> _! I 1 ! 1- madon is true, complete, and accurate. SIGNATURE OF PRINCIPAL EXECUTIVE <br /> LA5T FIRST MI TITLE YEAR MO DAY OFFICER OR AUTHORIZED AGENT <br /> EPA Form 3310.1 00.77 PAGE OF <br /> ORIGINAL 1 1 <br /> 001 IS TRE'ATFO YARD 6 CISTRI9UTED A RFA RW?OFF FROM COAL PREPARATION PL <br /> ANdT ANY SINGLE 6PAB CANNOT EXCEED 45 MG/L FOR T S <br />