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PERMITTEE NAME/ADDRESS (/ ncl udeFacililyNamaLocationifDlffereno <br />NAME: <br />Bowie Resources LLC <br />ADDRESS: <br />PO Box 483 <br />NO. <br />EX <br />Paonia, CO 81428 <br />FACILITY: <br />BOWIE NO. 2 MINE <br />LOCATION: <br />5 MI NE OF TOWN ON CO HWY 133 <br />VALUE <br />PAONIA, CO 81428 <br />ATTN: BRADLEY E. HANSON, VICE PRES. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />C00044776 005A <br />PERMIT NUMBER I I DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY I MM /DD/YYYY <br />FROM — 9940412669- TO I Q9t3M26e9- <br />`� <br />37-11-3 cis 3t - )& r3 <br />Form Approved <br />OMB No. 2040 -0004 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />SR;DEER TRL DTC OR UNMD TRIB <br />External Outfall <br />No Discharge <br />PARAMETER <br />1 c fy under penalty of law that this document and all attachments were prepared under my d, cno <br />supen to the to accordance w mi a system designed to assure that qualm or personnel properly gather and <br />valuate tho mformatwn submitted Based on my inquiry of the person or persons who manage the <br />system, or those persons directly m.%nnsible for gathering the information, the information submdted rs, <br />to the best of my knowledge and belief, true, auurak, and v mplete I am aware that there arc a <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />EX <br />FREQUENCY <br />OF ANALYSIS <br />SAMPLE <br />TYPE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNITS <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />YPED OR PRINTED <br />Oil and grease visual <br />SAMPLE <br />...... <br />NUMBER <br />MM /DD/YYYY <br />,,,,,, <br />* * * * ** <br />MEASUREMENT <br />614—r- <br />8406610 <br />PERMIT <br />`..'" <br />Req. Mon. <br />Y =1;N =0 <br />*" "' <br />' "''* <br />... <br />* * * ** <br />Effluent Gross <br />REQUIREMENT <br />INST MAX <br />Weekly <br />VISUAL <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER <br />1 c fy under penalty of law that this document and all attachments were prepared under my d, cno <br />supen to the to accordance w mi a system designed to assure that qualm or personnel properly gather and <br />valuate tho mformatwn submitted Based on my inquiry of the person or persons who manage the <br />system, or those persons directly m.%nnsible for gathering the information, the information submdted rs, <br />to the best of my knowledge and belief, true, auurak, and v mplete I am aware that there arc a <br />` <br />TELEPHONE <br />DATE <br />..._� <br />�,. <br />rg.,fi ant <br />penlemUnsforsubmnwgfalse rfomanon,mcmm'a t. in, <br />n <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />YPED OR PRINTED <br />AUTHORIZED AGENT <br />AREA code <br />NUMBER <br />MM /DD/YYYY <br />—mma. t � ^ras, l lvry yr A%m r vrvu%l lvrva trcererence an a[cacr mencs nere/ <br />SETTLEABLE SOLIDS LIMIT APPLIES ONLY IF <10YR,24HR PRECIP EVENT IS CLAIMED. IF CLAIM APPROVED BY WQCD,TSS & IRON LIMITS WILL NOT BE APPLIED TO REPORTED MEASUREMENTS -SEE I.A.3, PP 4 -5 FOR <br />BURDEN OF PROOFREQUIREMENTS. OIL & GREASE- I.B.1.E, PG 9. QRTRLY SAMPLING INSTRUCTIONS - I.C.10, PG. 10. <br />EPA Form 3320.1 (Rev.01 106) Previous editions may be used. Page 2 <br />