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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 />SED. POND TO SYLVESTER GULCH <br />PERMIT NUMBER DISCHARGE NUMBER (SUBR MH) GUNIS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />FROM TO NO DISCHARGE <br />nl I L�. r��l I I I I�. vv11_unrvlJ, rI1LJILJLIV 1 <br />IVYIC: Keaa InSTrucuonS DeTOre c mpieung TnIS TOrm. <br />QUALITY OR LOADING <br />QUALITY OR CONCENTRATION <br />PARAMETER <br />NO. <br />FREQUENCY <br />SAMPLE <br />><. <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNIT <br />EX <br />OF <br />TYPE <br />ANALYSIS <br />OIL AND GREASE <br />SAMPLE <br />VISUAL <br />MEASUREMENT <br />NO <br />DISCHARGE <br />*.< <br />84066 1 O <br />.....lflT <br />f <br />EFFLUENT GROSS <br />Ft elUli2 t NT <br />................ <br />*** <br />IVIIVTH' <br />VIWAL: <br />SAMPLE <br />MEASUREMENT <br />r RIAT. <br />RE4i11 R EM.... <br />::::: <br />::: <br />.. <br />... .... .. <br />SAMPLE <br />.... ... <br />........ <br />MEASUREMENT <br />iPE. RM1tIIT'. <br />.:. <br />::. <br />R QLIIfZ�MENT.: <br />.:: <br />.:. <br />.. <br />SAMPLE <br />MEASUREMENT <br />MEASUREMENT <br />................. <br />SAMPLE <br />MEASUREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT.......... <br />........... <br />:::::::.:. <br />EQ>JIPEMFNT.::.... .. <br />.................................... ..................................................................................................................................,........................... <br />NAME / TITLE PRINCIPAL EXECUTIVE OFFICER i TELEPHONE DATE <br />I CERTIFY UNDER PENALTY OF LAW THAT THIS DOCUMENT AND ALL ATTACHMENTS WERE PREPARED UNDER MY <br />DIRECTION <br />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 O <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 />Weston NOPYIS AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT PENALTIES FOR SUBMTTING FALSE INFORMATION, SIGNATURE OF PRINCIPAL EXECUTIVE 970-929-5015 7/9/2015 <br />INCLUDING THE POSSIBILITY OF FINE AND IMPRISONMENT FOR KNOWING VIOLATIONS. <br />TYPED OR PRINTED OFFICER OR AUTHORIZED AGENT MM/DD/YYYY <br />(:(1MNAFMT ANIn FXPI AnIATInM (1F AAIV \/I(ll ATIf1AIIZ /Oaf �❑ �ff­a.,, h, A_—I Forms by WindowChem(707)864-0845;p/n11O90;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.F. <br />00202/980409-1716 PAGE 2 OF 2 <br />