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PERMITTEE 1• NATIONAL POLLUTANT D ARGE ELIMINATION SYSTEM (NPUES) FO Approved <br /> Facility Name,, e:' :_ :: I.: <br /> DISCHARGE TORING REPORT (L)MR) I O. 2000-0015 <br /> NAMEf_ i �MJ •>r{;.) t'L�t, Y i. ___-- (2-16 (17-19) <br /> ADDRE6Y_f). �. nr 1f'.i _ 1 T----- ! I -. �I / <br /> t „�Lf;�f1 �J1�rC1 <br /> ----LAKti"JON, C„LVRADD 80215 --------- PERMIT NUMBER oISCHAROE NUMBER <br /> ———— <br /> �j `f O __—__---_ MONITORING PERIOD <br /> FAr.ILL— DAY YEAR MO DAY <br /> LOCATION NeW Elk Mine --------- FROM — J - TO I r <br /> (20 21) -(22-21) (24-2.5) (26-27) U8-^ (.10-31) NOTE: Read instructions before Completing this form. <br /> (3 Card Only) QUANTITY OR LOADING (4 Card Only) QUALITY OR CONCENTRATION <br /> PARAMETER (46-53) (54-61) (38-45) (46-53) (54-61) NO FREOOUFNCY SAMPLE <br /> (3137) EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 62-63) (64 ) (69-70) <br /> SAMPLE - t �• <br /> MEASUREMENT <br /> F (.'I!• ( ( F ( 'ft ) Cl () • 1 6 y: A A A 4 <br /> PERMIT C.. <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT 4 3 o. 7 r~ J• ` ) J-10fc,^ <br /> ' PERMIT <br /> J( REQUIREMENT w F > a L x A C. <br /> a <br /> SAMPLE <br /> .I r S• MEASUREMENT ! t +• •r A. y + �•�.�� ,~ / C'�I !r ~~ ') `'� (.-•/ `L <br /> PERMIT <br /> f REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT fe <br /> I'I' �I f S z t 3 -I; { J i •w /� r i e :'� y (• J / L"✓ I< <br /> PERMIT <br /> REQUIREMENT � y_ 3. a$ <br /> # f 3 <br /> SAMPLE _ <br /> MEASUREMENT <br /> J PERMIT i /f <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> NAME/TITLE 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. AND BASED <br /> ON MY INOUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br /> ^ ,, ,• v ♦- OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION ! f F ~ <br /> IS TRUE, ACC RATE AND COMPLETE. I AM AWARE THAT THERE ARE SIG- <br /> �ivi,,, _ /�,.,,� NIFICANT PENAULTIES FOR SUBMITTING FALSE INFORMATION. INCLUDING j� - 303 989-5037 03 31 86 <br /> ro icntal CcordinaWr- THE POSSIBILITY OF FINE AND IMPRISONMENT. SEE 18 USC 4 1001 AND SIGNATURE OF PRINCIPAL EXECUTIVE <br /> 33 US C 4 1 31 9. (Penalties under these statutes may include fines up to $10,000 <br /> TYPED OR PRINTED a nd,or maximum imprisonment of between 6 months and 5years./ OFFICER OR AUTHORIZED AGENT A A NUMBER YEAR MO DAY <br /> COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br /> iE 1t <br /> I <br />'PA Form 3320-1 (Rev. 10-79) PREVIOUS EDITION TO BE USED (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) PAGE OF <br /> UNTIL SUPPLY 15 EXHAUSTED <br />