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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 />HI 1 IV. t\CIVIVG 1 I'll uuk' rl1(HIV, rmr-0IUCIV I <br />PARAMETER <br />OIL AND GREASE <br />VISUAL <br />84066 1 0 <br />(EFFLUENT GROSS <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />RWUIRI~IVIENT' <br />SAMPLE <br />MEASUREMENT <br />.:REQUIREMENT: <br />............... <br />............... <br />............... <br />............... <br />............... <br />SAMPLE <br />MEASUREMENT <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />C00038776 005 A COAL CONVEYOR RUNOFF (MB -3) <br />PERMIT NUMBER DISCHARGE NUMBER (SUBR MH) MNTRS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />FROM To NO DISCHARGE rX <br />NU I t: Keaq Instructions oeTOre c mpieting tnIS TOrfn. <br />QUALITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />EX <br />FREQUENCY <br />OF <br />ANALYSIS <br />SAMPLE <br />TYPE <br />VALUE VALUE UNITS VALUE VALUE VALUE <br />NO DISCHARGE <br />UNIT <br />ON <br />MOtVTH <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) Forms by WindowChem(707)864-0845;p/n11090;v5.0;1/1/96 <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.F. <br />00026/980409-1716 PAGE 2 OF 2 <br />SAMPLE <br />MEASUREMENT <br />pRMrt.:: <br />REQUIREMENT: <br />.......................................................................................................... <br />SAMPLE <br />...................................... <br />.................. <br />MEASUREMENT <br />R R NT <br />. U . EMS ...............:........:.....:....... <br />..............................I... <br />...... <br />................... <br />..:::::::.....::. .: <br />..................................... <br />.......... <br />............... <br />SAMPLE <br />MEASUREMENT <br />p :.11lEl::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: <br />ER.7.... <br />aEQ iiREME� T. <br />.... :' ;i ': iii <br />ii <br />SAMPLE <br />.................................. <br />. <br />...................... <br />........................................ <br />MEASUREMENT <br />PERMIT. ... <br />... <br />:.:.:.:.:.....:..:.:. <br />. ... ...:.:.: <br />:.:.:... ...:.:..:.... <br />: : <br />.: <br />.:. <br />. <br />.. <br />FkEQU hFM NT .. <br />..:.: <br />:..........::: ::::::::::: <br />::'..:..:.:...:::...:`.: :.: <br />........... ............... <br />..... ...... <br />,:, <br />... <br />. . <br />.:. <br />................................................ _....................................................................................................,......... <br />NAME / TITLE PRINCIPAL EXECUTIVE OFFICER <br />.................................................. <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 />:,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 IAND COMPLETE, I AM AWARE THAT THERE ARE SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION, <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />970-929-50157/6/2016 <br />INCLUDING THE POSSIBILITY OF FINE AND IMPRISONMENT FOR KNOWING VIOLATIONS. <br />TYPED OR PRINTED <br />OFFICER OR AUTHORIZED AGENT <br />t <br />MM/DD/YYYY <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) Forms by WindowChem(707)864-0845;p/n11090;v5.0;1/1/96 <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.F. <br />00026/980409-1716 PAGE 2 OF 2 <br />