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PERMITTEE NAME /ADDRESS: <br />NAME: <br />MOUNTAIN COAL COMPANY, LLC <br />ADDRESS: <br />WEST ELK MINE <br />QUALITY OR LOADING <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 />SOMERSET, CO 81434 <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />C00038776 F_ 004 A POND MB -2R (BACKWASH & RUNOFF) <br />PERMIT NUMBER DISCHARGE NUMBER (SUBR MH) MNTRS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />FROM To NO DISCHARGE <br />f; 1 1 PC ttCI I h K. VVILLIAIVIJ, I'KCJIUt1V I <br />NOTE: Read instructions betore c mpleting this torm. <br />QUALITY OR LOADING <br />QUALITY OR CONCENTRATION <br />PARAMETER <br />NO. <br />FREQUENCY <br />SAMPLE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNIT <br />EX <br />IF <br />TYPE <br />ANALYSIS <br />SOLIDS, TOTAL <br />SAMPLE <br />1/90 <br />GRAB <br />DISSOLVED <br />MEASUREMENT ! <br />(19) <br />70295 1 0 <br />PERNEIT;II. <br />EFFLUENT GROSS <br />FtilizNFI <br />EQ. .:...M.......... <br />N o DISCHARGE <br />mg /I <br />QT1t YGf�BI <br />; :: <br />OILAND GREASE <br />SAMPLE <br />VISUAL <br />MEASUREMENT <br />NA <br />NA <br />84066 1 0 <br />F?;ERIYiIT .... <br />;RE".IR MEiV'f; '; <br />' <br />1NE�i l... <br />UAL <br />'EFFLUENT GROSS <br />................. <br />SAMPLE <br />MEASUREMENT <br />FERfiIEIT !::::!:::::::::!!!!:'''.. <br />... .::::::1:1:11::::::!::::::::::: <br />R EQiI I fZ F MN <br />1 1 1 <br />.. <br />...... <br />SAMPLE <br />..... <br />MEASUREMENT <br />p�RMIT <br />RFQtJ IFREMENT . <br />.... <br />.... ..... <br />... <br />SAMPLE <br />..... .... <br />. ... <br />.... <br />.. . <br />MEASUREMENT <br />FE12]UIIT <br />REQili ............. <br />EMBT <br />... .. <br />. <br />SAMPLE <br />MEASUREMENT <br />RE�{11)If2ENIENT <br />...........,..... . ....... <br />.......... <br />71 <br />SAMPLE <br />.............................. <br />..... ..... <br />MEASUREMENT <br />:1:1:1:1::::::::: <br />R BQL11 fZ N1 �N : <br />:::::::..::::::::::::::::: <br />.......... <br />::::::::::: <br />;: r. <br />......... <br />......... <br />. . ....... <br />. . . ................. <br />. ......... <br />NAME / TITLE PRINCIPAL EXECUTIVE OFFICER <br />............................... <br />........... <br />TELEPHONE <br />DATE <br />I CERTIFY UNDER PENALTY OF LAW THAT THIS DOCUMENT AND ALL ATTACHMENTS WERE PREPARED UNDER MY <br />DIRECTION OR SUPERVISION IN ACCORDANCE WITH A SYSTEM DESIGNED TO ASSURE THAT QUALIFIED PERSONNEL <br />:PROPERLY GATHER AND EVALUATE THE INFORMATION SUBMITTED. BASED ON MY INQUIRY OF THE PERSON OR <br />yt, <br />Weston Norris <br />PERSONS WHO MANAGE THE SYSTEM, OR THOSE PERSONS DIRECTLY RESPONSIBLE FOR GATHERING THE <br />-� INFORMATION, THE INFORMATION SUBMITTED IS, TO THE BEST OF MY KNOWLEDGE AND BELIEF, TRUE, ACCURATE, <br />AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION. <br />- INCLUDING THE POSSIBILITY OF FINE AND IMPRISONMENT FOR KNOWING VIOLATIONS. <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />970 - 929 -5015 <br />4/21/2015 <br />TYPED OR PRINTED <br />OFFICER OR AUTHORIZED AGENT <br />I MM /DD /YYYY <br />(`nAAnnI:nlT AKIrl CVOI AK;AI'In KI nr ANIV Innl ATInNIC <br />Forms by WindowChem(707 <br />)864- 0845;p/n17o90;v5.0;1/1/96 <br />TSS & TOTAL IRON LIMITS WILL BE WAIVED, AND SETTLEABLE SOLIDS LIMIT APPLIED FOR < 10YR, 24HR PRECIP EVENT -SEE I.A.2, PG 5, FOR REQUIREMENTS. 30 DAY AVG IS HIGHEST <br />MONTHLY AVERAGE DURING REPORTING PERIOD. QUARTERLY SAMPLING & REPORTING INSTRUCTIONS- I.C.11. OIL & GREASE -SEE 1.B.1.17. <br />00002/980409 -1716 PAGE 2 OF 2 <br />