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PERMITTEE NAME /ADDRESS (Include Facility Name /Location ff Different) <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 />oiSi:HARGE MONITORINV RIEf'UR (DMR) <br />C00036684 001 -X <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY MM /DD /YYYY <br />0110112114 01/31/2014 <br />DMR Mailing ZIP CODE: 80467 <br />MINOR <br />(SUBR JC) ROUTT <br />CHRONIC WET TESTING FOR 001A <br />External Outfall <br />No Discharge <br />PARAMETER <br />1 certify under penalty of law that this document and all attachments Aers prepared under my directi on or <br />supervision in accordance wth a system designed to assure fiat 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 hue accurate and com let, l am aware that there are <br />significant penalties for submitting false imormahon including the possibility of fine and imprisonment for <br />novnng vicfations <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 />%Effect Statre 7Day Chronic <br />Pimephales <br />TCP6C S 0 <br />See Comments <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />* * * * ** <br />* " *` *' <br />* * * "* <br />Req. Mon. <br />MN VALUE <br />* *' * ** <br />* * * * ** <br />% <br />Quarterly <br />GRAB -3 <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />1 certify under penalty of law that this document and all attachments Aers prepared under my directi on or <br />supervision in accordance wth a system designed to assure fiat 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 hue accurate and com let, l am aware that there are <br />significant penalties for submitting false imormahon including the possibility of fine and imprisonment for <br />novnng vicfations <br />- _ -�-- -� - --- -_ <br />a.� <br />'•� Vy e`V -- <br />TELEPHONE <br />DATE <br />1 f.'y�a �� � j•,I�.-' `^'F �� - ti,. {r,, <br />• '�! ` C��-` <br />/ F <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code <br />NUMBER <br />M /DD /YYYY <br />TYPED OR PRINTED <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SEE PART I A.4 OF PERMIT FOR DETAILS OF TEST PROCEDURE. RPT LOWEST %AT WHICH STATISTICALLY SIGNIF DIFFBTWN TEST & CONT USING TEST CODE "S ". RPT IC25 USING TEST <br />CODE "P" ATTACH CHRONIC TOX TEST RPT TO DMR <br />a : osrli =• >wu I (Re\.01106) Previous editions may be urea. <br />