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PERMITTEE NAMEIADDRESS: <br />NAME: <br />MOUNTAIN COAL COMPANY, LLC <br />ADDRESS: <br />WEST ELK MINE <br />FREQUENCY <br />P.O. BOX 591 <br />SOMERSET CO 81434 <br />FACILITY: <br />WEST ELK MINE <br />LOCATION: <br />APPX 1 MI E OF TOWN ON HWY 133 <br />VALUE <br />SOMERSET, CO 81434 <br />ATTN- KEITH R. WILLIAMS. PRESIDENT <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />00638776 I 016 VV ACUTE WET TESTING FOR 016A <br />PERMIT NUMBER DISCHARGE NUMBER (SUBR MH) GUNIS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />LROM 1/ 1 To 1 12/ NO DISCHARGE <br />NOTE: Read instructions before completing this form. <br />PARAMETER <br />QUALITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />FREQUENCY <br />SAMPLE <br />>< <br />EX <br />OF <br />ANALYSIS <br />TYPE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNIT <br />LC50 STATRE 48HR ACU <br />DAPHNIA MAGNA <br />SAMPLE <br />MEASUREMENT <br />(23) <br />PERMIT <br />REQUIREMENT <br />QTRLY <br />GRAB <br />TAM3C 1 0 <br />EFFLUENT GROSS SEE COMMENTS <br />PERCENT <br />LC50 STATRE 96HR ACU <br />PIMEPHALES <br />SAMPLE <br />MEASUREMENT <br />(23> <br />PERMIT <br />REQUIREMENT <br />QTRLY <br />GRAB <br />TAN6C 1 0 <br />EFFLUENT GROSS <br />NO D <br />PERCENT <br />Did effluent consist of surface <br />SAMPLE <br />MEASUREMENT <br />water only for the entire <br />PERMIT <br />quarter? <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAME ! TITLE PRINCIPAL EXECUTIVE OFFICER TELEPHONE <br />D A T E <br />I CERTIFY UNDER PENALTY OF LAW THAT DOCUMENT AND ALL ATTAOHMENTS WERE PREPARED UNDER MY <br />9 <br />I CE <br />FIROPV ON OR SUPEAND EVALUATE IN ATE THE WITH A SYSTEM SUBMITTED. AS TO A95URE THAT Y OF THE PERSONNEL <br />P RSORLY GATHER AND EVALUATE THE IOR THOSE ERE NSDI. EASED ON MV SIBLE Y OF THE PERSON O <br />.PERSONS WHO NO! THE RSUBMIT OR THOSE PERSONS DIRECTLY RESPONSDLE FOR GATHERING THE <br />EINFORMATION <br />{ '. IN D COMPLETE. THE WRE T AT THERE TED IG. SIGNIFICANT BEST PE A KNOWLEDGE MIT ING A TRUC, A=ZT : <br />WOStOrt NOrfIS INCLUDING I AM AWARE THAT THERE ARE MIENIFOR PENALTIES FOR suewnNG FALSE wFORAwrDN. SIGNATURE OF PRINCIPAL EXECUTIVE 970 - 929 -5015 <br />'� INCLUgNG THE P0551EIlRV OF FlNE AND IMPRISONMENT FOR KNOWING VKKATk)NE. <br />1/6/2015 <br />MM/DDIYYYY <br />TYPED OR PRINTED OFFICER OR AUTHORIZED AGENT <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) F.,.sby VV,Ddu.Chem(707 )664- OU5;pin11090;Y5.0;111196 <br />SEE I.A.5, PP- 6 -7, FOR DETAILS OF TEST PROCEDURE. LC50- STATISTICAL POINT ESTIMATE WHICH IS LETHAL TO 50% TEST ORGANISMS, AND ATTACH ACUTE TOXICITY TEST REPORT FORM <br />TO DMR. WET TESTING IS NOT REQUIRED WHEN DISCHARGE DOES NOT CONTAIN ANY MINE WATER FOR THE ENTIRE CALENDAR QUARTER. SEE I.A.a, PP3 - ALTERNATE LIMITATIONS. <br />00121/980409 -1716 PAGE 1 OF 1 <br />