Laserfiche WebLink
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 />000034142 024 -A <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY MM /DD/YYYY <br />1/1/2015 3/31 /2015 <br />Form Approved <br />OMB No. 2040 -0004 <br />DMR Mailing ZIP CODE: 80467 -9704 <br />MINOR <br />Mine Dewatedng to Sedimentation Basin Prior to Disc <br />External Outfall <br />No Discharge e l <br />NAME IfITLE PRINCIPAL EXECUTIVE OFFICER I certly under penalty of law that thn dorbment " all allachmnts were prepared under my d"ion o" <br />super —on m accordance wdh a system donned to amra that qua4fied personn 1 property gather and <br />valuate the Information submitled. eased on my Inquky of the person or persons who manage the <br />s system. or those persons directly responsible ler gathering the inforranmon, the information wbmmed is. <br />to the best of my hrwwMdgo and belief. tore. eccurete. and —plate. I em aware that there are <br />R%'ian 14-{?lsvtrn sigmficantpenalb" tesubrnitung false Information. includmg the posa mbilntyof fine and Imprisonment for SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />known woiatwns. AUTHORIZED AGENT <br />TYPED OR PRINTED <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />Oil and grease sample required if visible sheen is observed. Qtrly sampling instructions - I.C.12, pg 11. <br />EPA Form 3320 -1 (Rev.01 /06) Previous editions may be used. <br />TELEPHONE DATE <br />9;b S70 X750 <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />FREQUENCY <br />SAMPLE <br />PARAMETER <br />EX <br />OF ANALYSIS <br />I <br />TYPE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNITS <br />Oil and grease visual <br />SAMPLE <br />MEASUREMENT <br />8406610 <br />PERMIT <br />..... <br />Mon. <br />Y =1;N =0 <br />" "" <br />' " "" <br />" " "'" <br />" "'" <br />Twice Per <br />VISUAL <br />Effluent Gross <br />REQUIREMENT <br />INST MAX <br />I <br />Month <br />NAME IfITLE PRINCIPAL EXECUTIVE OFFICER I certly under penalty of law that thn dorbment " all allachmnts were prepared under my d"ion o" <br />super —on m accordance wdh a system donned to amra that qua4fied personn 1 property gather and <br />valuate the Information submitled. eased on my Inquky of the person or persons who manage the <br />s system. or those persons directly responsible ler gathering the inforranmon, the information wbmmed is. <br />to the best of my hrwwMdgo and belief. tore. eccurete. and —plate. I em aware that there are <br />R%'ian 14-{?lsvtrn sigmficantpenalb" tesubrnitung false Information. includmg the posa mbilntyof fine and Imprisonment for SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />known woiatwns. AUTHORIZED AGENT <br />TYPED OR PRINTED <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />Oil and grease sample required if visible sheen is observed. Qtrly sampling instructions - I.C.12, pg 11. <br />EPA Form 3320 -1 (Rev.01 /06) Previous editions may be used. <br />TELEPHONE DATE <br />9;b S70 X750 <br />0,4/2,f 6- <br />AREACede <br />I NUMBER <br />MMIDDrfYYY <br />05/08/2013 <br />Page 4 <br />