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PERMITTEE NAME/ADDRESS: <br />NAME: <br />MOUNTAIN COAL COMPANY, LLC <br />ADDRESS: <br />WEST ELK MINE <br />P.O. BOX 591 <br />QUALITY OR CONCENTRATION <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 />j- <br />C00038776 005ACOAL CONVEYOR RUNOFF (MB -3) <br />PERMIT NUMBER DISCHARGE NUMBER(SUBR MH) MNTRS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />FROM TO NO DISCHARGE <br />A I IN: Ktl I H K. VVILLIANIS, I'Kt51UtN I <br />NOTE: Read instructions before c mpleting this form. <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 />OF <br />TYPE <br />ANALYSIS <br />OIL AND GREASE <br />SAMPLE <br />'VISUAL <br />MEA>< <br />SUREMENT <br />84066 1 0 <br />WRThIl <br />NO D, <br />C3NI*..­............ <br />EFFLUENT GROSS <br />................ <br />[VIOtVTH:::::::::::::::::::::::: <br />SAMPLE <br />_ <br />MEASUREMENT <br />K EfZMIT <br />T; <br />REQt11RENIEN .. <br />...... <br />...................................................................................................... <br />SAMPLE <br />................... <br />............................... <br />.... <br />MEASUREMENT <br />T <br />;.:::. <br />1EQi! GEMENT::' <br />f' <br />.............................. <br />................... <br />.................................... <br />SAMPLE <br />MEASUREMENT <br />RFQUIf2EMEN F;:: <br />. <br />............................. <br />....... <br />.................. <br />SAMPLE <br />MEASUREMENT <br />P..ERMIT <br />REQi�I12EMEN f <br />.................................. <br />................... <br />..................................... <br />SAMPLE <br />MEASUREMENT <br />P:EfN[17 <br />FtE DIRE E. F <br />... M..1,.... <br />.......................... <br />SAMPLE <br />............................................................... <br />MEASUREMENT <br />F'ER(Lt IT :::::::::::::: <br />` ::::::::::: <br />:::::::::::::::: ::: : <br />REQU :ME:;: <br />' <br />' <br />... <br />....... <br />.. <br />.. <br />.... .......................... <br />.. <br />NAME / TITLE PRINCIPAL EXECUTIVE <br />OFFICER <br />I <br />1 CERTIFY UNDER PENALTY OF <br />�4.•.•...... <br />LAW THAT THIS DOCUMENT AND ALL ATTACHMENTS WERE PREPARED UNDER MY <br />... . ... .. .... <br />.... <br />TELEPHONE <br />. . ..... <br />DATE <br />DIRECTION OR SUPERVISION IN <br />!PROPERLY GATHER AND EVALUATE <br />':PERSONS WHO MANAGE THE <br />ACCORDANCE WITH A SYSTEM DESIGNED TO ASSURE THAT QUALIFIED PERSONNEL <br />THE INFORMATION SUBMITTED. BASED ON MY INQUIRY OF THE PERSON OR <br />SYSTEM, OR THOSE PERSONS DIRECTLY RESPONSIBLE FOR GATHERING THE <br />Weston Norris <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 />1 INCLUDING THE POSSIBILITY OF FINE AND IMPRISONMENT FOR KNOWING VIOLATIONS. <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />970-929-5015 <br />7/9/2015 <br />TYPED OR PRINTED <br />OFFICER OR AUTHORIZED AGENT <br />MM/DD/YYYY <br />f`nh nnnCAIT AKIM CVoI AAI ATI n KI f1C AAly vnf%I ATInKIC <br />Formsby WindowChem(707)864-0845;p/n11090;vS.0;111196 <br />TSS & TOTAL IRON LIMITS WILL BE WAIVED, AND SETTLEABLE SOLIDS LIMIT APPLIED FOR <=10YR, 24HR PRECIP EVENT -SEE I.A.3, 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.1.1'. <br />00026/980409-1716 PAGE 2 OF 2 <br />