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PERMITTEE NAME/ADDRESS (Include Facility Name/Location if <br />RW'. Energy LLC <br />ADDRESS: 5652 County Road 120 <br />Hesperus, CO 81326 <br />FACILITY: KING COAL MINE <br />LOCATION: 4424 COUNTY ROAD 120 <br />HESPERUS,CO 81326 <br />ATTN: DAN REDETZKI, MINE ENGINEER <br />NATIONAL POLLUTANT DISCHARGE ELEvE NATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />COG850001 <br />002-A <br />PERMIT NUMBER <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM/DD/YYYY <br />SAMPLE <br />TYPE <br />MM/DD/YYYY <br />10/01/2016 <br />UNITS <br />12/31/2016 <br />Form Approved <br />OMB No. 2040- 0004 <br />DMR Mailing ZIP CODE: 81326 <br />MINOR <br />(SUBR GB) LPLTA <br />NORTH SIDI POND TO HAY GULCH <br />External Outfall <br />No Discharge® <br />PARAMETER <br />f certify ender pemdry of Imv that this dommem end au hrimblements wuep pea ander my <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />EX <br />FREQUENCY <br />OF ANALYSIS <br />SAMPLE <br />TYPE <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 />Gina Nance, V.P. <br />person or persons nho manage the system. or those persons directly responsible for solum i, <br />heinsoZtmthe informationsubmittedis, tothe best ormylmmvledgeand bef, e, <br />****** <br />*^*°^* <br />^^^^^'• <br />****ib^ <br />TYPED OR PRINTED <br />8406610 <br />Effluent Gross <br />PERMIT <br />REQT T <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 />In <br />NAME/ME PRINCIPAL EXECUTIVE OFFICER <br />f certify ender pemdry of Imv that this dommem end au hrimblements wuep pea ander my <br />\ <br />TELEPHONE <br />DATE <br />direction or supervise in zcoordrmce ith a system desh,ned to ssbrre that gbombed <br />personnel properly gather and evaluate the mforma8on submitted. posed on my inquiry of the <br />970-385-4528 <br />01022017 <br />1 i <br />Gina Nance, V.P. <br />person or persons nho manage the system. or those persons directly responsible for solum i, <br />heinsoZtmthe informationsubmittedis, tothe best ormylmmvledgeand bef, e, <br />/) <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />and enmplete. i sm a ere then mere ere significant penalties ter snbrrdmng false <br />ormohm, including the possibility of the and imprisonment for l onving violations. <br />TYPED OR PRINTED <br />AREA Code I N[JMBER <br />/DD/YYYY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SETTLEABLE SOLIDS LIMIT WAIVED 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 Form 3320-1 (Rev.01/06) Previous editions may be used. 12/03/2015 Page 1 <br />