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PERMITTEE NAME /ADDRESS: <br />NAME: MOUNTAIN COAL COMPANY, LLC <br />ADDRESS: WEST ELK MINE <br />P.O. BOX 591 <br />SOMERSET CO 81434 <br />FACILITY: WEST ELK MINE <br />LOCATION: APPX 1 MI E OF TOWN ON HWY 133 <br />SOMERSET, CO 81434 <br />ATTN: KEITH R. WILLIAMS, PRESIDENT <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />—000038776 012 WJACUTE WET TESTING AT 012A <br />PERMIT NUMBER DISCHARGE NUMBER (SUBR MH) GUNIS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />FROM TO NO DISCHARGE <br />NOTE: Read instructions before com pleting this form <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) Forms by VVindowChem( 707 )864- 0B45;p/n1109ON5.0;1/1/96 <br />SEE I.A.5, PP. 6 -7, FOR DETAILS OF TEST PROCEDURE. REPORT LC50 - STATISTICAL POINT ESTIMATE WHICH IS LETHAL TO 50% OF THE TEST ORGANISMS, AND ATTACH ACUTE TOXICITY <br />TEST REPORT FORM TO DMR. <br />00121/980409 -1716 PAGE 1 OF 1 <br />QUALITY OR LOADING <br />QUALITY OR CONCENTRATION <br />PARAMETER <br />I>< <br />NO. <br />FREQUENCY <br />SAMPLE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNIT <br />EX <br />OF <br />ANALYSIS <br />TYPE <br />LC50 STATRE 48HR ACU <br />DAPHNIA MAGNA <br />SAMPLE <br />MEASUREMENT <br />(23) <br />TAM3C 1 0 <br />EFFLUENT GROSS SEE COMMENTS <br />NO D <br />PERCENT <br />FERM4T <br />REQUIREMENT <br />UTRLY <br />GRAB <br />LC50 STATRE 96HR ACU <br />PIMEPHALES <br />SAMPLE <br />MEASUREMENT <br />(23) <br />TAN6C 1 0 EFFLUENT <br />GROSS <br />PERCENT <br />REF"T <br />AEQUIREMENT' <br />{ITRhY <br />.... ....... . <br />GRAB <br />SAMPLE <br />MEASUREMENT <br />PEF"T <br />REQUIREMENT:: <br />SAMPLE <br />MEASUREMENT <br />PERMTl.. . <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />KRL41T <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />Pi;RMiT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PCRMiT <br />REQUIREMENT <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER TELEPHONE <br />DATE <br />I CERTIFY UNDER PENALTY OF LAW THAT THIS DOCUMENT AND ALL ATTACHMENTS WERE PREPARED UNDER MY <br />DIRECTION OR SUPERVISION IN ACCORDANCE WITH A SYSTEM DESIGNED TO ASSURE THAT QUALIFIED PERSONNEL <br />PROPERLY GATHER AND EVALUATE THE INFORMATION SUBMITTED. BASED ON MY INOUIRY OF THE PERSON OR <br />PERSONS WHO MANAGE THE SYSTEM, OR THOSE PERSONS DIRECTLY RESPONSIBLE FOR GATHERING THE <br />NFORMATION. THE RIFORMATON 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 SIGNATURE OF PRINCIPAL EXECUTIVE 970 -929 -5015 <br />INCLUDING THE POSSIBIL" OF FINE AND IMPRISONMEM FOR KNOWING VIOLATIONS. <br />1/15/2014 <br />TYPED OR PRINTED OFFICER OR AUTHORIZED AGENT <br />MM/DD/YYYY <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) Forms by VVindowChem( 707 )864- 0B45;p/n1109ON5.0;1/1/96 <br />SEE I.A.5, PP. 6 -7, FOR DETAILS OF TEST PROCEDURE. REPORT LC50 - STATISTICAL POINT ESTIMATE WHICH IS LETHAL TO 50% OF THE TEST ORGANISMS, AND ATTACH ACUTE TOXICITY <br />TEST REPORT FORM TO DMR. <br />00121/980409 -1716 PAGE 1 OF 1 <br />