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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 />ATTN: KEITH R. WILLIAMS, PRESIDENT <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />C00038776 00 WACUTE WET TESTING FOR 004A <br />PERMIT NUMBER DISCHARGE NUMBER (SUBR MH) GUNIS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />FROM TO NO DISCHARGE 0 <br />NOTE: Read instructions before c mpleting this form. <br />PARAMETER <br />QUALITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />FREQUENCY <br />SAMPLE <br />[>< <br />EX <br />OF <br />ANALYSIS <br />TYPE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNIT <br />LC50 STATRE 48HR ACU <br />DAPHNIA MAGNA <br />SAMPLE <br />MEASUREMENT <br />(23) <br />1/90 <br />GRAB <br />TAM3C 1 0 <br />EFFLUENT GROSS SEE COMMENTS <br />PERCENT <br />PERh/EIT;;;', <br />ti lift iviE V F ' <br />::::::::::::::::.:.:.:.:.:.:.:.:I, <br />::;::::::::::::::::::::::::::::::::::::: <br />2T LY <br />GF A3 <br />LC50 STATRE 96HR ACU <br />PIMEPHALES <br />SAMPLE <br />MEA UREMENT � <br />(23) <br />1/90 <br />GRAB <br />TAN6C 1 0 <br />GROSS SEE COMMENTS <br />NO DISCHARGE <br />PERCENT: <br />' .: <br />: : <br />TRL <br />:EFFLUENT <br />I <br />. <br />Did effluent consist of surface <br />SAMPLE <br />MEASUREMENT <br />water only for the entire <br />PRN11T :':'' <br />quarter?EQiiulNl <br />i' <br />NAME / TITLE PRINCIPAL EXECUTIVE OFFICER TELEPHONE <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 />DATE <br />PROPERLY GATHER AND EVALUATE THE INFORMATION SUBMITTED. BASED ON MV 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 />` jAND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION, SIGNATURE OF PRINCIPAL EXECUTIVE 970-929-5015 <br />Weston Norris INCLUDING THE POSSIBILITY OF FINEAND IMPRISONMENT FOR KNOWING VIOLATIONS. <br />7 7/(1/2016 <br />/ J <br />OFFICER OR AUTHORIZED AGENT <br />TYPED OR PRINTED <br />MM/DD/YYYY <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) Forms by WindowChem(707)864-0845;p/n11090;Y5.0;1/1/86 <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 />00017/980409-1716 PAGE 1 OF 1 <br />