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` 1J NATIONAL POLLUTA HARGF_EL IMINATION SYSTEM <br /> 1 DISCIIARG IVORING REPORT ;y rayed <br /> 7 C_J NO. 158-ROO73 <br /> l-r T CO3IL W" P PL A'IT <br /> i;AI ~ ALt INSTRUCTIONS <br /> 1 i,1 4'573 1. Provide dates for period wvered by this report in spaces warped"REPORTING PERIOD". 4 <br /> l 2. Enter eeponed minialum, averaEc mid maximum values under"QUANTITY"and"CONCENTRATION" <br /> Ia-iv 14-1e1 IlT.nal in Ute units specified for each paramete. a. apprupirste. pu not enter values in boxes containing <br /> aslencks. "AVERAGE" is average compated over actual time discharge is operating. "MAXIMUM" <br /> ` _ and"MINIMUM"are extreme values observed durii:g the repc,Ung pedcl <br /> A 1'"4)t�3 Mh 1` 1211 3 Specify the number of analyzed samples th it exceed the maximum(and/or minfmrm as appropriate) f <br /> —_-- -- perm,,rondttiona in the colamns labeled"Nu. Ex." if none,enter"O". <br /> ST PERMIT NUNISE� pis SIC - LATITUDE LONGITUDE _ 4, Spec frc ueeic o[analysis for each parameter as No. anal sax No days.Y v Y Y Y / Y (e.g., "3!7"is squ re- <br /> Iao-au uA-aR 424•2e1 Iae•an ue•tel 430-211 leut to 3 m.slyvos performed every 7 do)1,) If continuous enter"CONT." ' <br /> S specify sample type("grab"or'i—he composite")as applicable. If Irequeacy was arni(Duous, <br /> enter •NA". <br /> Rl PORI INO PERIOD. FROM �VE <br /> H ^ t 1 TO -7J9 _/1 (h 1, 6. Appropriate signature is iegafred on bottom of this form. <br /> R MO DAY YEAR NO DAY 7. Remove rartoa end-W.copy for yuur recutda. <br /> S. Fold along dotted lines, staple and mail Original to office specified In permit <br /> 464 e_al_ _ILe-711 <br /> tFpt (9 card only) QUANTITY �- _ (l cud only) — CONCENTRATION FHEOUENr,:Y _ <br /> tea-a3 to Au I�•ei! ems.e`I r:-w OF SAMPLE <br /> PARAMETER --. _ -___ --_ ._ _--_ _ -_ __ -__._ -._ _ - <br /> MININIIM AVENAtilt MAXIMUM UH1YS _ CH0.. - MINIMUM AV----- MAXINNM UNI Ts' ,NO - TYPE <br /> Ex ANALYSIS <br /> i : 11.' 114 C.tl"I IUIf REPORTED IS # « 10 # # « # # # # IS <br /> i t ItGJ - - — ------ ---- <br /> PERMIT MbU <br /> GONOITION # « (f # # IS « IS _1a ♦♦ « * # « # « fl # .--- 1/7_-__- IN <br /> I ii11; T( T,L GISS REPORTED IS in <br /> G/DA « -#-_ -- -- - « « «-«Y <br /> MG/L <br /> I/9O GR <br /> « « # k « (�'-�#) # « # « # <br /> _)tis T�'T'�I_ jl)cif 14EPORTSO # « « # « # « « it p « _-- \ w IS if IS <br /> PERMIT KG/UA , <br /> riCONDITION « « « # # « « 30 V90 CO <br /> REPORTED <br /> i PERMIT —_. - - - KG/VNY i_- - MG/L <br /> -1-'• 4 ---- — —« 4 IS p it IL. M # �7 # ') # # # # « # Te -- — ::iJ CO <br /> CONDITION <br /> Pif v l LI) REPORTED IS <br /> PERM , <br /> P F.RAtt T U --- S(V <br /> I •C`. ) CONDITION « it a IS i St « « # # « # # ` g « # # a 900 1/90 GR <br /> ` 14' [L 6 &1E1,• VIS11AI REPORTED ati40 « IS « IS <br /> PERM I r -- - - - <br /> A �. v 11 coF/OITt-N Y « « R « « « Y IS IS # G # 0 # # # # # 10 1/90 VI <br /> REPORTED <br /> 1 +I PERMIT , <br /> CONDITI Otl <br /> REPORTED <br /> CONOI TION <br /> NAME OF PRINCIPAL EXECUTIVE OFFICER` TITLE Or THE OFFIC.R DA Te <br /> ---i---'-- 1 carflfy that 1 oar lam/fler with fhn InforsUon contained in titleW ;�il7l)T't"AN� <br /> 0:EwS I bG N7- - ^Y,G� !'t re{iort and that to Ore best of my knowledge and bolls!such!n(nr- - 3 --- ------- <br /> !1 ration Is true, complain,and accurate, SIGNATURE OF PRINCIPAL EXECUTIVE <br /> LAST— FIRST MI TITLE YEAR I DAY OFFICER OR AUTHORIXEO AGENT <br /> EPA Fora.I320.100.72) -�--- PAGE OF ' <br /> ORIGINAL 1 1 <br /> 001 I"; SEi-LFO 'W4C 14ATER FROM COAL BASIN-MINE ANY tiINGLE GRAB CANNOT <br /> c XCEE-) 45 MG/L FIYR TSS <br />