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PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different) <br />NAME: <br />Blue Mountain Energy Inc <br />ADDRESS: <br />3607 CR 65 <br />NO. <br />EX <br />Rangely, CO 81648 <br />FACILITY: <br />DESERADO MINE <br />LOCATION: <br />3607 CR 65 <br />VALUE <br />RANGELY, CO 81648 <br />ATTN: ALAN HILLARD, MINE MGR <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />000038024 025-A <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM/DD/YYYY I MM/DD/YYYY <br />FROM 01/01/2016 1 To 03/31/2016 <br />Form Approved <br />OMB No. 2040-0004 <br />DMR Mailing ZIP CODE: 81648 <br />MINOR <br />(SUBR DW) RBLAN <br />RP4 SEDT POND TO RED WASH <br />External Outfall <br />No Discharge ELI <br />PARAMETER <br />lrnmq"nam.—L v-tIiay,Iem&mcm"menu,ma.hmm3werrprpradnmlrrmydlr""""' <br />npmwl+ a nnLmae wlNa ytlem dcunnalln name deal gnallfni prn ncl prnpMy ga3her ander <br />—1'i- II e'minrmamm.uh-rud 13—d ;,.".y nupnry "f ft prrvm or renonc nha nwnacr the <br />,y-m,orth—p--di—ty re'p+mlhl,"'galhcnng lh¢mfi+rmmtnn, the iiiii—bon s,,b I Uia <br />nl m InrvcJdc a,nJ wir.mIc1 <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />EX <br />FREQUENCY <br />OF ANALYSIS <br />SAMPLE <br />-HYPE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNITS <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />TYPED OR PRINTED <br />Oil and grease visual <br />SAMPLE <br />...... <br />NUMBER <br />MM/DD/YYYY <br />""" <br />""" <br />""" <br />MEASUREMENT""" <br />840661 0 <br />Effluent Gross <br />PERMIT <br />REQUIREMENT <br />"`"" <br />Req. Mon, <br />INST MAX <br />Y=1;N=0 <br />... <br />" "' <br />""" <br />"•"' <br />Twice Per Month <br />VISUAL <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER <br />lrnmq"nam.—L v-tIiay,Iem&mcm"menu,ma.hmm3werrprpradnmlrrmydlr""""' <br />npmwl+ a nnLmae wlNa ytlem dcunnalln name deal gnallfni prn ncl prnpMy ga3her ander <br />—1'i- II e'minrmamm.uh-rud 13—d ;,.".y nupnry "f ft prrvm or renonc nha nwnacr the <br />,y-m,orth—p--di—ty re'p+mlhl,"'galhcnng lh¢mfi+rmmtnn, the iiiii—bon s,,b I Uia <br />nl m InrvcJdc a,nJ wir.mIc1 <br />�� - <br />TELEPHONE <br />DATE <br />970 <br />675�4�72Scott <br />04/25/2016 <br />Wanstedt, Environmental Engineer <br />.mAom am ewarc <br />pape.tnnumd"ng3.nemchldmg Ulepnsvludy nl fine and lmpnwnmmlf rAnnwmg <br />mlm. <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />TYPED OR PRINTED <br />AUTHORIZED AGENT <br />AREA Code <br />NUMBER <br />MM/DD/YYYY <br />l UmmCN I J ANU CAYLANA I IUN Ur AN T VIOLA I IUNS tKereren ce all attachments here) <br />TSS & TOTAL IRON LIMITS WILL BE WAIVED FOR 10YR,24HR PRECIP. EVENT- SEE I.A.1., PG. 3. FOR REQUIREMENTS.OIL & GREASE REPORTING - I.B.1.A.,PG. 13. QRTRLY SAMPLING INSTRUCTIONS - I.C.7., PG. 14. <br />EPA Form 3320-1 (Rev.01/06) Previous editions may be used, 05/11/2011 Page 2 <br />