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PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different) <br />NAME: Oxbow Mining LLC <br />ADDRESS: PO Box 535 <br />Somerset, CO 81434-0535 <br />FACILITY: SANBORN CRK & ELK CRK MINES <br />LOCATION: 3737 HIGHWAY 133 <br />SOMERSET, CO 81434 <br />ATTN: Mike Ludlow Exec VP <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />000000132 016-A <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM/DD/YYYY MM/DD/YYYY <br />09/01/2015 09/30/2015 <br />Form Approved <br />OMB No. 2040-0004 <br />DMR Mailing ZIP CODE: 81424-0535 <br />MINOR <br />GUNIS <br />SURFACE RUNOFF TO ELK CREEK <br />External Outfall <br />No Discharge <br />PARAMETER <br />1 certify under penalty of law that this document and all attachments were prepared under my direction or <br />supervision in accortlance with a system designed to assure that qualified personnel properly gather and <br />valuate the information submitted. Based on my inquiry of the person or persons who manage the <br />system. or those persons directly responsible for gathering the information, the Information submitted is. <br />to the best of my knowledge and belief. true, accurate. and complete. I am aware that there are <br />sgnlflcantpenalties mrsubmitting false nformation.lncludmgthe posslb+rtyonmeand imprisonment for <br />nowng violations. <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />EX <br />FREQUENCY <br />OF ANALYSIS <br />SAMPLE <br />TYPE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNITS <br />Oil and grease visual <br />84066 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />*""* <br />'•***• <br />****** <br />*•~~ <br />~•*** <br />PERMIT <br />REQUIREMENT <br />*`***• <br />Req. Mon. <br />INST MAX <br />Y=1;N=0 <br />•••••* <br />•*'•*' <br />`**`** <br />**•*'* <br />Monthly <br />VISUAL <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />1 certify under penalty of law that this document and all attachments were prepared under my direction or <br />supervision in accortlance with a system designed to assure that qualified personnel properly gather and <br />valuate the information submitted. Based on my inquiry of the person or persons who manage the <br />system. or those persons directly responsible for gathering the information, the Information submitted is. <br />to the best of my knowledge and belief. true, accurate. and complete. I am aware that there are <br />sgnlflcantpenalties mrsubmitting false nformation.lncludmgthe posslb+rtyonmeand imprisonment for <br />nowng violations. <br />I t� , <br />TELEPHONE <br />DATE <br />yv\\ �� :� <br />VIA <br />7Y�c�l6G <br />?2G-9z� S CG <br />, <br />1� "�%�4�%' <br />/SIGNATURE OF P. INCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />TYPED OR PRINTED <br />AREA Code NUMBER <br />MMIDDIYYYY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />TSS & TOTAL IRON LIMITS WILL BE WAIVED, AND SETTLEABLE SOLIDS LMT APPLIED FOR -1 HR PRECIP EVENT;SETTLEABLE SOLIDS LIMITS MAY BE WAIVED FOR >10YR,24HR <br />EVENT -SEE I.A.1, PP 4-5, AND I.A.2., P. 5 FOR RQMNTS. TDS MONITORING -SEE PART VI.A.2.G OF RATIONALE. 30 DAY AVG IS HIGHEST MONTHLY AVG DURING PERIOD RPTD. <br />EPA Form 3320-1 (Rev.01106) Previous editions may be used. 10/17/2013 Page 2 <br />