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PERMITTEE NAME /ADDRESS (Include Facility Name /LocationiiDifferent) <br />NAME: Twentymile Coal LLC <br />ADDRESS: 29515 Routt CR 27 <br />Oak Creek, CO 80467 <br />FACILITY: FISH CREEK TIPPLE <br />LOCATION: 29515 ROUTT COUNTY ROAD #27 <br />OAK CREEK, CO 80467 <br />ATTN: Patrick Sollars, GM <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />C00036684 001 -A <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY MM /DDrCM <br />10/01/2013 1 1 12/31/2013 <br />Form Approved <br />OMB No. 2040 -0004 <br />DMR Mailing ZIP CODE: 80467 <br />MINOR <br />(SUBR JC) ROUTT <br />POND "E" DISCHARGE TO FISH CRK <br />External Outfall <br />No Discharge <br />PARAMETER <br />'certify under penalty of law that this document and all attachments were prepared under my direction or <br />supervision in accordance with 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 <br />system, or those persons directly responsible for gathering the information, the information submitted is. <br />to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are <br />sgnificantpenalties for submitting false information. including the possibility of fine and imprisonment for <br />vowing violations. <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 />Oil and grease visual <br />840661 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />11/07/2013 <br />Page 2 <br />PERMIT <br />REQUIREMENT <br />* * * * «* <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />« * « « «« <br />*. *, «* <br />. « «. «« <br />« « « « «« <br />Twice Per <br />Month <br />VISUAL <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />'certify under penalty of law that this document and all attachments were prepared under my direction or <br />supervision in accordance with 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 <br />system, or those persons directly responsible for gathering the information, the information submitted is. <br />to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are <br />sgnificantpenalties for submitting false information. including the possibility of fine and imprisonment for <br />vowing violations. <br />J' <br />�/ • ° °" <br /><t' V y <br />TELEPHONE <br />DATE <br />! <br />/ O�A, vin .ip„/ C �..� <br />7.J <br />p, ry.,,, �l <br />/70 P(U 2?SC' <br />C Z�,, <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code <br />I NUMBER <br />MMIDDIYYYYI <br />TYPED OR PRINTED <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />TSS LIMIT WILL BE WAIVED FOR 10YR,24HR PRECIP EVENT - SEE BURDEN OF PROOF REQUIREMENTS UNDER I.A.4, PG 5.011- & GREASE - SEE 1.B.2. <br />AVG. DURING PERIOD REPORTED - SEE I.C.13. <br />30 DAY AVERAGE IS HIGHEST MONTHLY <br />EPA Form 3320 -1 (Rev.01106) Previous editions may be used. <br />11/07/2013 <br />Page 2 <br />