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PERMITTEE NAME /ADDRESS (Include Facility Name/Location if Different) NAME: Moffat County Mining LLC ADDRESS: 29515 Routt CR 27 Oak Creek, CO 80467 -9704 FACILITY: WILLIAMS FORK MINE LOCATION: 1030 CR 107 CRAIG, CO 81626 ATTN: Jerry Nettleton, Supv NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) DISCHARGE MONITORING REPORT (DMR) C00034142 003 -X PERMIT NUMBER DISCHARGE NUMBER MONITORING PERIOD MM /DD/YYYY MM /DD/YYYY 01/01/2014 12/31/2014 Form Approved OMB No. 2040 -0004 DMR Mailing ZIP CODE: 80467 -9704 MINOR Chronic WET Testing at 003A External Outfall No Discharge OKI` PARAMETER I certify under penalty of law that this document and an attachments were prepared under my direction or supery s' n in accordance win a system designed to assure that qualified personnel property gather and valuate the information bmitted Based on my inquiry of the person or persons who anage the system. , those persons directly responsible for gathering the information , the information submitted is to the best of my k or sub and beret, true. accurate and complete I m aware a that there are significant penalties for submitting false 'formation, including the possibility of fine and imprisonment for novnng violations. QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. EX FREQUENCY OF ANALYSIS SAMPLE TYPE VALUE VALUE UNITS VALUE VALUE VALUE UNITS %Effect Statre 7Day Chronic Pimephales TCP6C S 0 See Comments SAMPLE MEASUREMENT * * * * ** * * * * ** * * * * ** * * * ** * * * * ** PERMIT I REQUIREMENT * * * * ** * * * * ** * * * * ** 18 MN VALUE * * * * ** * * * * ** % Annual GRAB -3 NAME /TITLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of law that this document and an attachments were prepared under my direction or supery s' n in accordance win a system designed to assure that qualified personnel property gather and valuate the information bmitted Based on my inquiry of the person or persons who anage the system. , those persons directly responsible for gathering the information , the information submitted is to the best of my k or sub and beret, true. accurate and complete I m aware a that there are significant penalties for submitting false 'formation, including the possibility of fine and imprisonment for novnng violations. -- J , TELEPHONE DATE (6 t 1 Vv Wet ( 7-- , / et V � k.7V -Z7 S i �� ((U � l� �. �- Z(j-, SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT TYPED OR PRINTED AREA Code NUMBER PAMIDDriYYY COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) 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 STATISTICALLY SIGNIF DIFF WAS OBSERVED USING CODE "S ".RPT IC25 USING CODE "P ". IWC =18 %. ATTACH TOX REPORT FORM TO DMR. EPA Form 3320 -1 (Rev.01106) Previous editions may be used. 07/10/2013 Page 2