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PERMITTEE NAME /ADDRESS: <br />NAME: <br />MOUNTAIN COAL COMPANY, LLC <br />ADDRESS: <br />WEST ELK MINE <br />this torm. <br />P.O. BOX 591 <br />PARAMETER <br />SOMERSET CO 81434 <br />FACILITY: <br />WEST ELK MINE <br />LOCATION: <br />APPX 1 MI E OF TOWN ON HWY 133 <br />SAMPLE <br />SOMERSET, CO 81434 <br />A 717717 1 CI 1! <br />-`CHIC C 1'l l/"`1 nl Illlll nnrcIflrwlT <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) _ <br />(�00���� ��7� —NSSA SURFACE RUNOFF TO N FK GUNNISOi <br />I(SUBR PERMIT NUMBER DISCHARGE NUMBER MH) GUNIS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />FROM To NO DISCHARGE FXJ <br />TSS & TOTAL IRON LIMITS WILL BE WAIVED, AND SETTLEABLE SOLIDS LIMIT APPLIED FOR < 10YR, 24HR PRECIP EVENT -SEE I.A.2, PG 5, FOR REQUIREMENTS. 30 DAY AVG IS HIGHEST <br />MONTHLY AVERAGE DURING REPORTING PERIOD. QUARTERLY SAMPLING & REPORTING INSTRUCTIONS- I.C.11. OIL & GREASE -SEE I.B.1.F. <br />00170/980409 -1716 PAGE 2 OF 2 <br />PERMIT . . <br />Ivy I t: Keaa Instructions Detore COm <br />pleting <br />this torm. <br />PARAMETER <br />>< <br />QUALITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO <br />FREQUENCY <br />SAMPLE <br />VALUE VALUE UNITS VALUE VALUE VALUE <br />UNIT <br />EX <br />OF <br />ANALYSIS <br />TYPE <br />OIL AND GREASE <br />SAMPLE <br />SAMPLE <br />VISUAL <br />MEASUREMENT <br />* ** <br />MEASUREMENT <br />84066 1 0 <br />EFFLUENT GROSS <br />N O DISCHARGE <br />... <br />PE RMIT <br />REQUIREMENT <br />oNi� t <br />MONTH... <br />VISUAL :: <br />REQUIREMENT <br />SAMPLE <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />TELEPHONE <br />DATE <br />I CERTIFY UNDER PENALTY OF LAW THAT THIS DOCUMENT AND ALL ATTACHMENTS WERE PREPARED UNDER MY <br />MEASUREMENT <br />PROPERLY GATHER AND EVALUATE THE INFORMATION SUBMITTED. BASED ON MY WOUIRY OF THE PERSON OR <br />PERSONS WHO MANAGE THE SYSTEM. OR THOSE PERSONS DIRECTLY RESPONSIBLE FOR GATHERING THE <br />INFORMATION, THE INFORMATION SUBMITTED IS. TO THE BEST OF MY KNOWLEDGE AND BELIEF, TRUE, ACCURATE. <br />Weston Norris AND COMPLETE I AM AWARE THAT THERE ARE SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />970 - 929 -5015 <br />1 OI3I2O <br />INCLUDING THE POSSIBILITY OF FINE AND IMPRISONMENT FOR KNOWING VIOLATIONS. <br />PERMIT'' <br />13 <br />TYPED OR PRINTED <br />OFFICER OR AUTHORIZED AGENT <br />MM /DD/YYYY <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS fRefarenre all attarhmenN here) <br />Forms by WindowChem(707 )864- 0845;p/n11090;v5.0:111/96 <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT .. <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT:. . <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />TSS & TOTAL IRON LIMITS WILL BE WAIVED, AND SETTLEABLE SOLIDS LIMIT APPLIED FOR < 10YR, 24HR PRECIP EVENT -SEE I.A.2, PG 5, FOR REQUIREMENTS. 30 DAY AVG IS HIGHEST <br />MONTHLY AVERAGE DURING REPORTING PERIOD. QUARTERLY SAMPLING & REPORTING INSTRUCTIONS- I.C.11. OIL & GREASE -SEE I.B.1.F. <br />00170/980409 -1716 PAGE 2 OF 2 <br />PERMIT . . <br />REQUIREMENT' <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />TELEPHONE <br />DATE <br />I CERTIFY UNDER PENALTY OF LAW THAT THIS DOCUMENT AND ALL ATTACHMENTS WERE PREPARED UNDER MY <br />DIRECTION OR SUPERVISION W ACCORDANCE WITH A SYSTEM DESIGNED TO ASSURE THAT QUALIFIED PERSONNEL <br />PROPERLY GATHER AND EVALUATE THE INFORMATION SUBMITTED. BASED ON MY WOUIRY OF THE PERSON OR <br />PERSONS WHO MANAGE THE SYSTEM. OR THOSE PERSONS DIRECTLY RESPONSIBLE FOR GATHERING THE <br />INFORMATION, THE INFORMATION SUBMITTED IS. TO THE BEST OF MY KNOWLEDGE AND BELIEF, TRUE, ACCURATE. <br />Weston Norris AND COMPLETE I AM AWARE THAT THERE ARE SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />970 - 929 -5015 <br />1 OI3I2O <br />INCLUDING THE POSSIBILITY OF FINE AND IMPRISONMENT FOR KNOWING VIOLATIONS. <br />13 <br />TYPED OR PRINTED <br />OFFICER OR AUTHORIZED AGENT <br />MM /DD/YYYY <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS fRefarenre all attarhmenN here) <br />Forms by WindowChem(707 )864- 0845;p/n11090;v5.0:111/96 <br />TSS & TOTAL IRON LIMITS WILL BE WAIVED, AND SETTLEABLE SOLIDS LIMIT APPLIED FOR < 10YR, 24HR PRECIP EVENT -SEE I.A.2, PG 5, FOR REQUIREMENTS. 30 DAY AVG IS HIGHEST <br />MONTHLY AVERAGE DURING REPORTING PERIOD. QUARTERLY SAMPLING & REPORTING INSTRUCTIONS- I.C.11. OIL & GREASE -SEE I.B.1.F. <br />00170/980409 -1716 PAGE 2 OF 2 <br />