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PERMITTEE NAME/ADDRESS (Include Facility Name/Location if <br />R' GCC Energy LLC <br />ADDRESS: 5652 County Road 120 <br />Hesperus, CO 81326 <br />EACII.ITY: KING COAL MINE <br />LOCATION: 4424 COUNTY ROAD 120 <br />HESPERUS,CO 81326 <br />ATTN: DAN REDETZKI, MINE ENGINEER <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />COG850001001-A <br />I r-'fy ander penalty of law that this document and 0-0 attachments were prepared order my <br />detection or supervision In accordance wIIh a system desiymed to assure that qualified <br />per met rroperlygmamer and evaluate the information sobmined. Based on my inquhy of the <br />or persons who manage he system , or mesa persons 11rartly responsible far gathering <br />he wfornamon,me-formation mbretted is, to the best of my"covledge and belief,true, <br />rvrate and eamam plem.I aomm that there -a .!,Mr. penalties for sabmmMn false <br />arformatiom maludmgthe passibility of fine and imprisonment for Imowm� g violators. <br />PERMIT NUMBER <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM/DD/YYYY <br />SAMPLE <br />ME <br />MM/DD/YYYY <br />10/01/2016 <br />UNITS <br />12/31/2016 <br />Form Approved <br />ONE No. 2040- 0004 <br />DMR Mailing ZIP CODE: 81326 <br />MINOR <br />(SUBR GB) LPLTA <br />SOUTH SIDI POND TO HAY GULCH <br />External Outfall <br />No Discharge <br />PARAMETER <br />I r-'fy ander penalty of law that this document and 0-0 attachments were prepared order my <br />detection or supervision In accordance wIIh a system desiymed to assure that qualified <br />per met rroperlygmamer and evaluate the information sobmined. Based on my inquhy of the <br />or persons who manage he system , or mesa persons 11rartly responsible far gathering <br />he wfornamon,me-formation mbretted is, to the best of my"covledge and belief,true, <br />rvrate and eamam plem.I aomm that there -a .!,Mr. penalties for sabmmMn false <br />arformatiom maludmgthe passibility of fine and imprisonment for Imowm� g violators. <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />EX <br />FREQUENCY <br />OF ANALYSIS <br />SAMPLE <br />ME <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNITS <br />Oil and grease visual <br />SAMPLE <br />MEASUREMENT <br />****** <br />*****+ <br />*.,**** <br />e,.,**** <br />8406610 <br />Effluent Gross <br />PERMIT <br />REQUIEM4ENT <br />****** <br />Req.Mon. <br />INST MAX <br />Y=1;N=0 <br />'•*'•*'•* <br />****** <br />"***** <br />**^^** <br />Twice per <br />Month <br />VISUAL <br />NO DISCHARGE <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />I r-'fy ander penalty of law that this document and 0-0 attachments were prepared order my <br />detection or supervision In accordance wIIh a system desiymed to assure that qualified <br />per met rroperlygmamer and evaluate the information sobmined. Based on my inquhy of the <br />or persons who manage he system , or mesa persons 11rartly responsible far gathering <br />he wfornamon,me-formation mbretted is, to the best of my"covledge and belief,true, <br />rvrate and eamam plem.I aomm that there -a .!,Mr. penalties for sabmmMn false <br />arformatiom maludmgthe passibility of fine and imprisonment for Imowm� g violators. <br />TELEPHONE <br />DATE <br />V.P.person <br />Gina Nance, P <br />970-385-4528 <br />01/02/2017 <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />TYPED OR PRINTED <br />nxrw code N[7,ygER <br />ND/YYYY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SETTLEABLE SOLIDS ISIvIIT WANED FOR10- YR, 24 HR PRECIP EVENT SUBJECT TO BURDEN OF PROOF REQUIREMENTS INPART I.B.6. ANY ADDITIONAL DATA SHALL BE SUPPLIED TO THE <br />DIVISION WITHIN 48 HOURS. <br />EPA Farm 3320-1(Rev.01/06) Previous editions may be used. 12/03/2015 Page 1 <br />