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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: KENNETH COCHRAN. PRESIDENT
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
<br />DISCHARGE MONITORING REPORT (DMR)
<br />C00038776 019Ak
<br />NSSA SURFACE RUNOFF TO N FK GUNNISON
<br />PERMIT NUMBER DISCHARGE NUMBER (SUER MH) GUNIS
<br />EXTERNAL OUTFALL
<br />MONITORING PERIOD IMINOR
<br />FROM TO NO DISCHARGE
<br />NOTE. Read instructions before completinq this form
<br />PARAMETER
<br />QUALITY OR LOADING
<br />QUALITY OR CONCENTRATION
<br />NO.
<br />FREQUENCY
<br />SAMPLE
<br />I><
<br />VALUE VALUE UNITS VALUE VALUE VALUE
<br />DISCHARGE
<br />UNIT
<br />EX
<br />ANAOLYSIS
<br />TYPE
<br />OIL AND GREASE
<br />VISUAL
<br />SAMPLE
<br />MEASUREMENT
<br />***
<br />84066 1 0
<br />EFFLUENT GROSS
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<br />SAMPLE
<br />MEASUREMENT
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<br />77
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<br />NAME / TITLE PRINCIPAL EXECUTIVE OFFICER
<br />TELEPHONE
<br />D A T E
<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 />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 />Weston Norris AND COMPLETE I AM AWARE THAT THERE ARE SIGNIFICANT PENALTIES FOR SUBMRTING FALSE INFORMATION,
<br />SIGNATURE OF PRINCIPAL EXECUTIVE 970-929-5015
<br />4/21/2016
<br />INCLUDING THE POSSIBILITY OF FINE AND IMPRISONMENT FOR KNOWING VIOLATIONS
<br />MM/DD/YYYY
<br />TYPED OR PRINTED I
<br />OFFICER OR AUTHORIZED AGENT
<br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) Forms by WmdowChem(707)864-0845,p/n11090,V50,1/1/96
<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 I.B.1.F.
<br />00170/980409-1716 PAGE 2 OF 2
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