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PERMIT? EE NAME /ADDRESS (Include Facility Name /Location if Different) <br />NAME: Twentymlle 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 />DSCHARGE MONITORING REPORT (DMR) <br />C00036684 01Y -X <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY MM /DD/YYYY <br />01/01/2014 03/31/2014 <br />DMR Mailing ZIP CODE: 80467 <br />MINOR <br />(SUBR JC) ROUTT <br />CHRONIC WET TESTING FOR 001A <br />External Outfall <br />No Discharge 0 <br />PARAMETER <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 />SAMPLE <br />Pimephales <br />TCP6C S 0 <br />MEASUREMENT <br />I <br />PERMIT <br />' * "' "* <br />"" <br />"'" <br />100 <br />`.... <br />% <br />Quarterly <br />GRAB -3 <br />See Comments — <br />REQUIREMENT <br />MN VALUE <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of law that this document and all attachments were prepared under my direction or TELEPHONE DATE <br />supervision in accordance Nth 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 T�F B� fy"� <br />to the best of my hnoy,ledge and belief hue accurate and co nplet, I any aware that there are <br />significant penalties for submitting false information including the possibility of fine and imprisonment for SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR' ^`�/ /14) 3 <br />-knowing molahons AUTHORIZED AGENT gREA Code NUMBER I M /DD/ <br />TYPED OR PRINTED <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SEE I.A.4 FOR DETAILS OF TEST PROCEDURE. IF THERE IS A STAT DIFF RPTRESULTS ON THIS OUTFALL. IF NOT,RPT "NO DISCHARGE" & COMPLETE OUTFALL 001X. RPT LOWEST % AT <br />WHICH STATISTICALLY SIGNIF DIFF BETWEEN TEST& CONT USING TEST CODE "S" RPT IC25 USING TEST CODE "P" ATTACH CHRON TOX TEST RPT TO DMR <br />EF FDrm :S2u -I ( a •.E• V06) Precious editions may be used. !O f 0 1 <br />