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PERMITTE '• 1 '- ' •' I :;•_1. L .:,,'.'�.„'_1 NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (.NYDhS) Form Approved <br /> Facility Nat DISCHARGE MONITORING REPORT ) OMB No. 2000-0015 <br /> �' 'u-j ., 1 DMR <br /> (; f (2-16) (17.19) <br /> NAME _ <br /> A _DDRESYP. 0. Ii{.: 'a <br /> ___- U'I/Cl•7• �,Il r;f 1 ',''`'�11 ^L15 ___--_--- PERMIT NUMBER DISCHARGE NUMBER CHG 1,:,"a 8J' J <br /> __--_---_ MONITORING PERIOD <br /> FA(+ILM - _________ YEAR MO DAV YEAR MO DAY <br /> LOCATION New Elk Mine FROM it I TO /� ! 5 I j <br /> ---- --------- - <br /> (20-21) t22 zq (24.25) u6-27) (28.29) 110-311 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) (5461) NO FREQOUFENCY SAMPLE <br /> (32 37) EX ANALYSIS>-< TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 6263) (6468) (69J0) <br /> SAMPLE <br /> MEASUREMENT <br /> I PERMIT , <br /> REQUIREMENT ,�. y �:. t }k dt k A X tt.. •► t : I: is ii >P' <br /> SAMPLE <br /> 11.'i I I T(11 ',f !' MEASUREMENT l a 4 e k 1F 4 d <br /> PERMIT (' <br /> REQUIREMENT , .s A' $ L !! # <br /> >f <br /> SAMPLE <br /> MEASUREMENT y I k a t <br /> PER <br /> W1T <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT I, * A k <br /> PERMIT - <br /> "I REQUIREMENT s. 4 # <br /> SAMPLE <br /> ( iS ( MEASUREMENT <br /> VI `i(11!( PERMIT <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 M - <br /> ON Y INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br /> Da7vi17 1'1• Stout OBTAINING THE INFORMATION. 1 BELIEVE THE SUBMITTED INFORMATION �N���� <br /> L y,�-I ,,7I� ;S TRUE. ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIG- Y 4 <br /> -i''vir ari:Yntal Coordhiatfr NWICANT PENALTIES FOR SUBMITTING FALSE INFORMATION. INCLUDING �/t� ��7(��C O•�•� O� �� C <br /> THE POSSIBILITY OF FINE AND IMPRISONMENT. SEE 18 U.S.C. S 1001 AND SIGNATURE OF PRINCIPAL EXECUTIVE V 07 .J J V <br /> 33 USCS 1319. /Penalties under these statutes may include fines up to $10.0 X1 <br /> TYPED OR PRINTED and/or maximum imprisonment of between 6 months and 5 years./ OFFICER OR AUTHORIZED AGENT A A NUMBER YEAR MO DAY <br /> CODE <br /> COMMENT AND EXPLANATION OF ANY VICLATIONS (Reference all attachments here) <br /> I I t I I „I, , ; I t , { Ttli . 1�Ei-1WI I 1f <br /> ^ �; t?E � Ittl� i•LP1 <br /> J <br /> NU 'I ny (- 2- 1 <br /> PA Form 3320-1 (Re.. 10-79)-PREVIOUS EDITION TO BE USED (REPLACES EPA FORM O WHICH MAY NOT BE USED.) ,E OF <br /> UNTIL SUPPLY IS EXHAUSTED <br />