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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 />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />C00038776 012 WACUTE WET TESTING AT 012A <br />PERMIT NUMBER DISCHARGE NUMBER (SUBR MH) GUNIS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />FROM To NO DISCHARGE <br />/"LI 1IY. 1\LIVIYL 111 VVV111 \/"'LI Y, 1 1\LVIVLIYI IYV IF.1-tlVdu IIID LIULiLIV113 UV I VIC LUI II ICLIII LI IIJ If 1111. <br />PARAMETER QUALITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY,SAMPLE <br />VALUE VALUE UNITS VALUE VALUE VALUE UNIT EX OF TYPE <br />ANALYSIS <br />LC50 STATRE 48HR ACU <br />SAMPLE <br />DAPHNIA MAGNA <br />MEASUREMENT <br />TAM3C 1 0 <br />RERMIT :— <br />EFFLUENT GROSS SEE COMMENTSQUIREME�T <br />LC50 STATRE 96HR ACU <br />SAMPLE <br />pE RMl1 <br />. <br />.:::::.:.. <br />NO <br />D <br />PIMEPHALES MEASUREMENT <br />TAN6C 1 0 p;Efta!iFf;7;;; <br />EFFLUENT GROSSREQUIREME IT: <br />SAMPLE <br />MEASUREMENT <br />..................................... ................... .. . <br />PERMIT <br />REQ111ZEMEIVT <br />(23) <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 />00121/980409-1716 PAGE 1 OF 1 <br />SAMPLE <br />MEASUREMENT <br />pE RMl1 <br />. <br />.:::::.:.. <br />.. <br />REQt11REIdIENT <br />...................... <br />...................... <br />SAMPLE <br />..................................... <br />.................. <br />MEASUREMENT <br />REQJIREMENT. <br />............................. <br />................... <br />..................................... <br />.................. <br />SAMPLE <br />MEASUREMENT <br />p:E♦ZMIT <br />F2QUIREIVIEIVT.: <br />............ <br />................ <br />SAMPLE <br />............................................................... <br />................... <br />..................................... <br />MEASUREMENT <br />P:ERhttIT .::: <br />.. .. ... <br />.. .... .... <br />: .::: .:::.. <br />F�E{�UIftEMENT: <br />.. .:::::. .:.:: <br />................................. <br />........ <br />NAME / TITLE PRINCIPAL EXECUTIVE OFFICER <br />TELEPHONE <br />DATE <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 />1 PERSONS WHO MANAGE THE SYSTEM, ORTHOSE PERSONS DIRECTLY RESPONSIBLE FOR GATHERING THE <br />:INFORMATION, THE INFORMATION SUBMITTED IS, TO THE BEST OF MY KNOWLEDGE AND BELIEF, TRUE, ACCURATE. <br />COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION. <br />Weston Norris <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />970-929-5015 <br />7/6/2016 <br />I'!AND <br />INCLUDING THE POSSIBILITY OF FINE AND IMPRISONMENT FOR KNOWING VIOLATIONS. <br />TYPED OR PRINTED <br />OFFICER OR AUTHORIZED AGENT <br />MM/DD/YYYY <br />!`llnnBnCnIT AKIn I=VMI ANIArIr Kl nr AnI-L 1n1 Ar!nKIC <br />Forms by WindowChem(707)864-0845:n101090:v5.0: <br />111/96 <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 />00121/980409-1716 PAGE 1 OF 1 <br />