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PERMITTEE NAME /ADDRESS (Include Facility Name/Location ff Different) <br />NAME: Moffat County Mining LLC <br />ADDRESS: 29515 Routt CR 27 <br />Oak Creek, CO 80467 -9704 <br />FACILITY: WILLIAMS FORK MINE <br />LOCATION: 1030 CR 107 <br />CRAIG, CO 81626 <br />ATTN Jerry Nettleton, Supv <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />000034142 FLOW -A <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD /YYYY MM /DD/YYYY <br />07/01/2013 09/30/2013 <br />DMR Mailing ZIP CODE: <br />MINOR <br />Total Flow <br />External Outfall <br />Form Approved <br />OMB No 2040 -0004 <br />80467 -9704 <br />No Discharge <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of law that this document and all attachments were prepared under my direction or <br />supervision in accordance wth a system designed to assure that qualified personnel properly gather and <br />valuate the information submitted Based on my inquiry of the person or persons who manage the ; ! �i <br />' .,,/ system or those persons directly responsible for gathering the informaton, the information submitted is ei { f_ _ <br />' lY.er R to the best of my knowledge and belief true accurate and complete I am aviare that there are <br />�•'•" " L' C 1 i V significant penalties for submitting false information including the possibility offine and imprisonment for SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />knowing violations AUTHORIZED AGENT <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />Report total flow from 003A, 022A and 024A. <br />TELEPHONE I DATE <br />AREA code NUMBER MMIDDWW <br />EPA Form 3320 -1 (Rev.01 /06) Previous editions may be used. 07/10/2013 Page 1 <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />FREQUENCY <br />SAMPLE <br />PARAMETER <br />EX <br />OF ANALYSIS <br />TYPE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNITS <br />Flow, In conduit or thru treatment plat <br />SAMPLE <br />° * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />MEASUREMENT <br />+ % t/, j <br />/ i 6'. <br />500501 0 <br />PERMIT <br />4.03 <br />Req. Mon. <br />MGD <br />" " " "` <br />* * " *`* <br />* " * "* <br />" "•` <br />Monthly <br />CALCTD <br />Effluent Gross <br />REQUIREMENT <br />I 30DA AVG <br />DAILY MX <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of law that this document and all attachments were prepared under my direction or <br />supervision in accordance wth a system designed to assure that qualified personnel properly gather and <br />valuate the information submitted Based on my inquiry of the person or persons who manage the ; ! �i <br />' .,,/ system or those persons directly responsible for gathering the informaton, the information submitted is ei { f_ _ <br />' lY.er R to the best of my knowledge and belief true accurate and complete I am aviare that there are <br />�•'•" " L' C 1 i V significant penalties for submitting false information including the possibility offine and imprisonment for SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />knowing violations AUTHORIZED AGENT <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />Report total flow from 003A, 022A and 024A. <br />TELEPHONE I DATE <br />AREA code NUMBER MMIDDWW <br />EPA Form 3320 -1 (Rev.01 /06) Previous editions may be used. 07/10/2013 Page 1 <br />