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PERMITTEE NAME/ADDRESS (Include Facility Nama&ocation if Different) <br />NAME: Oxbow Mining LLC <br />ADDRESS: PO Box 535 <br />Somerset, CO 81434-0535 <br />FACILITY: SANBORN CRK & ELK CRK MINES <br />LOCATION: 3737 HIGHWAY 133 <br />SOMERSET, CO 81434 <br />ATTN: Mike Ludlow Exec VP <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />000000132 I 015 -W <br />PERMIT NUMBER I I DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM/DD/YYYY MM/DD/YYYY <br />01/01/2015 03/3112015 <br />DMR Mailing ZIP CODE: <br />MINOR <br />Form Approved <br />OMB No. 2040 -0004 <br />81424 -0535 <br />GUNIS <br />ACUTE WET TESTING FOR 015A <br />External Outfall <br />No Discharge <br />LPJ <br />PARAMETER <br />1 Ca" under penaftyof Ivor that Oft document and at! a ftachmamsv re prepared under my direction or <br />supervision in accordance wah a system designed to assure lost quawed personnsi pmperly gather and <br />uata the tformaton submitted. Based on my srquity of the person or persons who menage the <br />system, or those persons directly responsible for gathering the information, the mformatsn submitted a <br />to the beat of my knowledge and belief, true. soounde, and complete I am a re that ahem are <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 />LC50 Statre 96Hr Acute Pimephales <br />SAMPLE <br />""'• <br />" *• "•• <br />""'"" <br />'" •" <br />'" " <br />ATTACH ACUTE TOXICITY TEST <br />REPORT FORM TO DMR. <br />MEASUREMENT <br />10/17/2013 <br />Page 1 <br />TAN6C 1 0 <br />PERMIT <br />^"•"•* <br />"•"•*" <br />"*" '" <br />100 <br />'" " <br />"""" <br />% <br />Quarterly <br />GRAB <br />Effluent Gross <br />REQUIREMENT <br />MN VALUE <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER <br />1 Ca" under penaftyof Ivor that Oft document and at! a ftachmamsv re prepared under my direction or <br />supervision in accordance wah a system designed to assure lost quawed personnsi pmperly gather and <br />uata the tformaton submitted. Based on my srquity of the person or persons who menage the <br />system, or those persons directly responsible for gathering the information, the mformatsn submitted a <br />to the beat of my knowledge and belief, true. soounde, and complete I am a re that ahem are <br />TELEPHONE <br />DATE <br />nr�/ <br />SIGNATURE OF FrRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />K' f <br />T—t`� <br />stnificant penaftnes for submftdrtg false urformation including the possiWity of fare and imimsonment to, <br />ghotations <br />/ <br />TYPED OR PRINTED <br />arrEncode <br />NUMBER <br />MM/DDfr(YY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SEE LAA A, PP 5 -6 FOR DETAILS OFTEST PROCEDURE. REPORT LC50 - STATISTICAL PINT WSTIMATE WHICH ISLETHAL TO 50% OF TEST ORGANISMS, AND <br />ATTACH ACUTE TOXICITY TEST <br />REPORT FORM TO DMR. <br />EPA Form 3320 -1 (Rev.01106) Previous editions may be used. <br />10/17/2013 <br />Page 1 <br />