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PERMITTEE NAME /ADDRESS (Include Facility Name/Location if Different) <br />NAME: Moffat County Mining LLC <br />ADDRESS: 29515 Routt CR 27 <br />Oak Creek, CO 80467 -9704 <br />FACILITY: WILLIAMS FORK MINE <br />LOCATION: 1030 CR 107 <br />CRAIG, CO 81626 <br />ATTN: Jerry Nettleton, Supv <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />C00034142 003 -A <br />PERMIT NUMBER I DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY MM /DD /YYYY <br />07/01/2015 09/30/2015 <br />Form Approved <br />OMB No. 2040 -0004 <br />DMR Mailing ZIP CODE: 80467 -9704 <br />MINOR <br />No. 6 Mine to Williams Fork River <br />External Outfall <br />No Discharge <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER 1 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 valuate the 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 />�f/ to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are <br />t1 Ok f'S.0 r1 significant penalties for submitting false information, including the possibility of fine and imprisonment for SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />nowtng violations. AUTHORIZED AGENT <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />Oil and grease sample required if visible shee is observed. Qtrly sampling instructions - I.C.12, pg 11. <br />EPA Form 3320 -1 (Rev.01 /06) Previous editions may be used. <br />TELEPHONE DATE <br />`7761 J70 2-2 Sti <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />FREQUENCY <br />SAMPLE <br />PARAMETER <br />EX <br />OF ANALYSIS <br />TYPE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNITS <br />Nickel, potentially dissolvd <br />SAMPLE <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />MEASUREMENT <br />013221 0 <br />PERMIT <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />Req. Mon. <br />Req. Mon. <br />ug /L <br />Monthly <br />GRAB <br />Effluent Gross <br />REQUIREMENT <br />30DA AVG <br />DAILY MX <br />Selenium, potentially dissolvd <br />SAMPLE <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />MEASUREMENT <br />013231 0 <br />Effluent Gross <br />PERMIT <br />REQUIREMENT <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />Req. Mon. <br />30DA AVG <br />Req. Mon. <br />DAILY MX <br />ug /L <br />Monthly <br />GRAB <br />Oil and grease <br />SAMPLE <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />MEASUREMENT <br />0358210 <br />PERMIT <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />10 <br />mg /L <br />Contingent <br />GRAB <br />Effluent Gross <br />REQUIREMENT <br />INST MAX <br />Chromium, trivalent total recoverablE <br />SAMPLE <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />MEASUREMENT <br />042621 0 <br />PERMIT <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />Req. Mon. <br />ug /L <br />Monthly <br />GRAB <br />Effluent Gross <br />REQUIREMENT <br />DAILY MX <br />Flow, in conduit or thru treatment plat <br />SAMPLE <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />MEASUREMENT <br />500501 0 <br />PERMIT <br />Req. Mon. <br />Req. Mon. <br />MGD <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />Monthly <br />INSTAN <br />Effluent Gross <br />REQUIREMENT <br />30DA AVG <br />DAILY MX <br />Solids, total dissolved <br />SAMPLE <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />MEASUREMENT <br />702951 0 <br />PERMIT <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />Req. Mon. <br />Req. Mon. <br />mg /L <br />Quarterly <br />GRAB <br />Effluent Gross <br />REQUIREMENT <br />30DA AVG <br />DAILY MX <br />Mercury, total (as Hg) <br />SAMPLE <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />MEASUREMENT <br />719001 0 <br />PERMIT <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />Req. Mon. <br />* * * * ** <br />ug /L <br />Monthly <br />GRAB <br />Effluent Gross <br />REQUIREMENT <br />30DA AVG <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER 1 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 valuate the 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 />�f/ to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are <br />t1 Ok f'S.0 r1 significant penalties for submitting false information, including the possibility of fine and imprisonment for SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />nowtng violations. AUTHORIZED AGENT <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />Oil and grease sample required if visible shee is observed. Qtrly sampling instructions - I.C.12, pg 11. <br />EPA Form 3320 -1 (Rev.01 /06) Previous editions may be used. <br />TELEPHONE DATE <br />`7761 J70 2-2 Sti <br />(V/21 711�- <br />AREACod. <br />I NUMBER <br />MM /DD/YYYY <br />07/10/2013 <br />Page 3 <br />