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PERMITTEE NAME/ADDRESS: <br />NAME: MOUNTAIN COAL COMPANY, LLC <br />ADDRESS: WEST ELK MINE <br />P.O. BOX 591 <br />SOMERSET CO 81434 <br />FACILITY: WEST ELK MINE <br />LOCATION: 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 />ACUTE WET TESTING FOR 011A <br />PERMIT NUMBER DISCHARGE NUMBER (SUBR MH) MNTRS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />FROM To NO DISCHARGE <br />Mi 1 IV. r\CI I-1-1 tC. VVILLI/AIVIJ, 1"IRCJIUCIN I NU I t: KeBd Instructions petore c mpleting tnls torm. <br />QUALITY OR LOADING 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 />TYPE <br />-j <br />ANAOLF <br />LC50 STATRE 48HR ACU <br />SAMPLE <br />DAPHNIA MAGNA <br />MEASUREMENT <br />(23) <br />TAM3C 1 0 <br />EFFLUENT GROSS SEE COMMENTSMPLE <br />I'FtNEII:! <br />. ��:: <br />NO D <br />PERCENT.'. <br />:'::::::::::::::::::::::::::::::::::::::::::: <br />QTF2LY(2AB; <br />LC50 STATRE 96HR ACU <br />SAMPLE <br />, <br />PIMEPHALES <br />MEASUREMENT <br />(23) <br />TAN6C 1 0 <br />p:E.l2!iIT;;;1 <br />EFFLUENT GROSS <br />R(1UIREME3yF <br />j <br />---___. <br />.__ <br />PERCENT <br />CiTRi 3' <br />GF2Fl€3 <br />SAMPLE <br />MEASUREMENT <br />PE RMT' <br />ill.:....,. <br />fZFMFNT:.:::::: <br />......... <br />...................................... <br />SAMPLE <br />................... <br />.................................... <br />MEASUREMENT <br />`pEt2MIT <br />REQi11REMENT <br />..... <br />.. ... <br />..... ...... ........ <br />SAMPLE <br />........ . . <br />. ... <br />MEASUREMENT <br />PFRNEIT <br />.......... <br />RFQUIRMF7 <br />SAMPLE <br />...................................... <br />MEASUREMENT <br />. PEI .. n[i17 <br />... <br />..... <br />REQUIREMENT. <br />.. <br />SAMPLE <br />........................................ <br />................................................................................................,... <br />. <br />MEASUREMENT <br />PERMIT. .... .:.:: <br />. .- ................ ..:::.: <br />: :: : ....:.. <br />::::::: :::::: . <br />ill:...... <br />REC2.. RUMEN € <br />I <br />................ <br />.................. <br />...................................,..................................,.,................................................................ <br />NAME / TITLE PRINCIPAL EXECUTIVE OFFICER <br />:I CERTIFY UNDER PENALTY OF LAW THAT THIS DOCUMENT AND ALL ATTACHMENTS WERE PREPARED UNDER MV. <br />-DIRECTION OR SUPERVISION IN ACCORDANCE WITH A SYSTEM DESIGNED TO ASSURE THAT QUALIFIED PERSONNEL <br />..............................................,..... <br />TELEPHONE <br />DATE <br />Weston Yt r NorY riS <br />.PROPERLY GATHER AND EVALUATE THE INFORMATION SUBMITTED. BASED ON MY INQUIRY OF THE PERSON OR <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 />970-929-5015 <br />7/9/2015 <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />TYPED OR PRINTED <br />OFFICER OR AUTHORIZED AGENT <br />MM/DD/YYYY <br />('.()PANAFNT ANin FY471 ANATIr)M ()F ANIV \/lr)i ATlr1NC <br />Forms by WindowChem(707)B64-0845;p/n11090;v5.0;1/1/96 <br />SEE I.A.5, PP. 6-7, FOR DETAILS OF TEST PROCEDURE, REPORT LC50 - STATISTICAL POINT ESTIMATE WHICH IS LETHAL TO 50% OF THE TEST ORGANISMS, AND ATTACH ACUTE TOXICITY <br />TEST REPORT FORM TO DMR. <br />00105/980409-1716 PAGE 1 OF 1 <br />