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PERMITTEENAME/ADDRESS ( Inc /udeFaci/ity Name/LocationifDifferenV <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 001A <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY MM /DD/YYYY <br />FROM - 691Q972m TO 69M&2eft <br />Form Approved <br />OMB No. 2040 -0004 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />SR/MINE WTR TO DEER TRAIL DTCH <br />External Outfall <br />No Discharge <br />PARAMETER <br />I'eddy under pensky of law that this document end all auachmenta were prepared undo, m due ton or <br />y <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 />to the best of my knowledge and behef, tine, accurate, and complete I am aware that there arc sigmfi'ant <br />- <br />? <br />/ <br />rPpenalties <br />Oiland grease visual <br />SAMPLE <br />...,., <br />I NUMBER <br />MWDD/YYYY <br />...... <br />.,.,,, <br />..... <br />.,.... <br />t <br />MEASUREMENT <br />840661 0 <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 />I'eddy under pensky of law that this document end all auachmenta were prepared undo, m due ton or <br />y <br />TELEPHONE <br />DATE <br />gather and <br />gn qua ponoms proper y ga <br />supervision mae 'nrdan'ewtha system dest designed hied 1 <br />aluate the information submitted Based on 'r mgwry of the person or persona who manage the <br />system, or those persons duectly respomrble fur gathering the mforma mn, the mf rmatmn submitted ta, <br />/� "1'7 <br />to the best of my knowledge and behef, tine, accurate, and complete I am aware that there arc sigmfi'ant <br />- <br />? <br />/ <br />rPpenalties <br />ne aubmuhng false mfoma on,mdudmg hepombtbtyoffine and tmpnsomnent( knowing <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code <br />I NUMBER <br />MWDD/YYYY <br />TYPED OR PRINTED <br />cVMMEN IS ANU EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <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, PG 4 -5 FOR <br />BURDEN OF PROOFREQUIREMENTS. OIL & GREASE - 1.6.1,3, PG 9. QRTRLY SAMPLING INSTRUCTIONS- I.C.10, PG. 10, <br />EPA Form 3320 -1 (Rev.01 /06) Previous editions may be used. Page 2 <br />