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PERMITTEE NAMEIADDRESS (Include Facility Name/Location if Different) <br />NAME: Oxbow Mining LLC <br />ADDRESS: PO Box 535 <br />Somerset, CO 81434 -0535 <br />FACILITY: SANBORN CRK & ELK CRK MINES <br />LOCATION: 3737 HIGHWAY 133 <br />SOMERSET, CO 81434 <br />ATTN: Mike Ludlow Exec VP <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />C00000132 015 -W <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY MM /DD/YYYY <br />07/01/2014 09130/2014 <br />Form Approved <br />OMB No. 2040 -0004 <br />DMR Mailing ZIP CODE: 81424 -0535 <br />MINOR <br />GUNIS <br />ACUTE WET TESTING FOR 015A <br />External Outfall <br />No Discharge <br />PARAMETER <br />I certify under penalty of law that this document and an 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 />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 />LC50 Statre 96Hr Acute Pimephales <br />TAN6C 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />AREA Code <br />NUMBER <br />I MM /DDIYYW <br />TYPED OR PRINTED <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SEE I.A.4.A, PP 5 -6 FOR DETAILS OFTEST PROCEDURE. REPORT LC50 - STATISTICAL PINT WSTIMATE WHICH ISLETHAL TO 50% OF TEST ORGANISMS, AND <br />ATTACH ACUTE TOXICITY TEST <br />PERMIT <br />I REQUIREMENT <br />` * * * ** <br />* * * * ** <br />* * * * ** <br />100 <br />MN VALUE <br />* * * * ** <br />* * * * ** <br />% <br />Quarterly <br />GRAB <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER <br />I certify under penalty of law that this document and an 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 />/J / _ /nr / <br />G r , <br />r , r <br />TELEPHONE <br />DATE <br />D <br />YLAt <br />/ <br />^ y/ �rJ(� <br />92e iz- —,� 6 `� 6 <br />/ <br />SIGNATURE OF PRI CIPAL EXECUTIVE OFFICER OR <br />r� �� <br />significant penaNies for submitting false information, including the possibility of fine and imprisonment for <br />1 ��/`Cn <br />knowing violations. <br />AUTHORIZED AGENT <br />AREA Code <br />NUMBER <br />I MM /DDIYYW <br />TYPED OR PRINTED <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SEE I.A.4.A, PP 5 -6 FOR DETAILS OFTEST PROCEDURE. REPORT LC50 - STATISTICAL PINT WSTIMATE WHICH ISLETHAL TO 50% OF TEST ORGANISMS, AND <br />ATTACH ACUTE TOXICITY TEST <br />REPORT FORM TO DMR. <br />EPA Form 3320 -1 (Rev.01106) Previous editions may be used. <br />10/17/2013 <br />Page 1 <br />