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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 I FLOW -A <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD /YYYY MM /DD/YYYY <br />10/0112014 12/31/2014 <br />DMR Mailing ZIP CODE: <br />MINOR <br />Total Flow <br />External Outfall <br />Form Approved <br />OMB No. 2040 -0004 <br />80467 -9704 <br />No Discharge <br />PARAMETER V <br />QUANTITY OR LOADING Q <br />QUALITY OR CONCENTRATION N <br />NO. F <br />FREQUENCY S <br />SAMPLE <br />VALUE V <br />VALUE U <br />UNITS V <br />VALUE V <br />VALUE V <br />VALUE U <br />UNITS E <br />Flow, in conduit or thru treatment plat S <br />SAMPLE * <br />* * * * ** * <br />* * * * ** * <br />* * * * ** * <br />* * * * ** <br />PERMIT 4 <br />4.03 R <br />Req. Mon. M <br />MGD * <br />* * * * ** * <br />* * * * ** * <br />* * * * ** * <br />* * * * ** M <br />Monthly C <br />CALCTD <br />Ice rtify under penalty of law that this document and all attachments were prepared under my duecbon or TELEPHONE DATE <br />sup accordance th a system designed to assure that qualified ' personnel properly gather and /n .__._..a.._.,- .,,,�_ <br />valuate the information submRletl Based on my - inquiry of the person or persons who manage the — <br />system or those perso s directly - responsible for gathering the information, the information submitted Is _ <br />to the best of y k W dg and belief ' , t a c t d complete I ware that there are ( t J <br />significant penaNies for subm tting false information. including the possibility of fine and imprisonment for SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR �. -� Z�i �� <br />TYPED OR PRINTED vowing ciolatlons AUTHORIZED AGENT <br />AREA Cotle NUMBER MIDD /YYYY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />Report total flow from 003A, 022A and 024A. <br />EPA Form 3320 -1 (Rev.01;06) Previous editions may be used. 07/10/2013 Page 1 <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />Report total flow from 003A, 022A and 024A. <br />EPA Form 3320 -1 (Rev.01;06) Previous editions may be used. 07/10/2013 Page 1 <br />