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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, Sup <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />C00034142 022 -X <br />PERMIT NUMBER I I DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY MM /DD /YYYY <br />01/01/2014 12/31/2014 <br />Form Approved <br />OMB No. 2040 -0004 <br />DMR Mailing ZIP CODE: 80467 -9704 <br />MINOR <br />Chronic WET Testing at 022A <br />External Outfall <br />No Discharge z <br />PARAMETER <br />I certify under penalty of law that his document and all attachments were prepared under my <br />- - drecon or <br />supe s c c designed t e that qualified pers I property gather and <br />valu t the submitted. Based my Inquiry f the person or persons who manage the <br />system. o those persons directly ' responsible for gathering - the information , the f at on submitted is <br />to the best i m y knowfetl e and belief, true. accurate d complete, I am aware that there are <br />significant penalties for submitting false information, including the possibility of fine and imprisonment for <br />nowing violations. <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 />TCP6CS 0 <br />See Comments <br />SAMPLE <br />MEASUREMENT <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />PERMIT <br />I REQUIREMENT <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />18 <br />MN VALUE <br />* * " " ** <br />" * * * *" <br />% <br />Annual <br />GRAB -3 <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />I certify under penalty of law that his document and all attachments were prepared under my <br />- - drecon or <br />supe s c c designed t e that qualified pers I property gather and <br />valu t the submitted. Based my Inquiry f the person or persons who manage the <br />system. o those persons directly ' responsible for gathering - the information , the f at on submitted is <br />to the best i m y knowfetl e and belief, true. accurate d complete, I am aware that there are <br />significant penalties for submitting false information, including the possibility of fine and imprisonment for <br />nowing violations. <br />TELEPHONE DATE <br />rl ze,e ^ (,'.�,� <br />��G (%/7r+ <.-71 <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />TYPED OR PRINTED <br />AREA Cade <br />NUMBER MM/DD /YYYY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SEE 1.B.3, FOR DETAILS OF TEST PROCEDURE. RPT RESULTS OF LETHALITY DERIVS AS "% EFFECT ", GROWTH &REPRODDERIVS AS "TOXICITY ". RPT LOWEST % EFFL AT WHICH <br />STATISTICALLY DIGNIF DIFF WAS OBSERVED USING CODE "S ".RPT IC25 USING CODE "P ". IWC =18 %. ATTACH TOX REPORT FORM TO DMR. <br />EPA Form 3320 -1 (Rev.OV06) Previous editions may be used. 07/10/2013 Page 2 <br />