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PERMITTEE NAME/ADDRESS: <br />NAME: MOUNTAIN COAL COMPANY, LLC <br />ADDRESS: WEST ELK MINE <br />5174 HIGHWAY 133 <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 011 W ACUTE WET TESTING FOR 011A <br />PERMIT NUMBER DISCHARGE NUMBER (SUBR MH) MNTRS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />FROM TO NO DISCHARGE <br />H I I IN. t\CININC 1 rl I-uu IKHIN, <br />t'KCJIUCIN 1 <br />ow I c: Keao Insrrucuons Derore compleung inls roan. <br />REQUIREMENT._ <br />QUALITY OR LOADING <br />QUALITY OR CONCENTRATION <br />. _...._..__ — . <br />NAME / TITLE PRINCIPAL EXECUTIVE OFFICER <br />TELEPHONE <br />PARAMETER <br />CERTIFY UNDER PENALLY 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 />NO. <br />FREQUENCY <br />SAMPLE <br />PROPERLY GATHER AND EVALUATE THE INFORMATION SUBMITTED. BASED ON MY INQUIRY OF THE PERSON OR <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />UNIT <br />EX <br />OF <br />TYPE <br />iMM/DD/YYYY <br />TYPED OR PRINTED OFFICER OR AUTHORIZED AGENT <br />ANALYSIS <br />LC50 STATRE 48HR ACU <br />SAMPLE <br />MEASUREMENT <br />(23) <br />DAPHNIA MAGNA <br />TAM3C 1 0 <br />EFFLUENT GROSS SEE COMMENTS <br />1'RM[i'! <br />F3EQUIR�MEN.. <br />:: I <br />NO DISCHARGE <br />PERCENT:::; <br />;; QTRLY <br />::::::::::::::::: <br />`: CRAB;`:;:; <br />LC50 STATRE 96HR ACU <br />SAMPLE <br />(23) <br />PIMEPHALES <br />MEASUREMENT <br />TAN6C 1 0PERM <br />IT. .. <br />QTRLY: <br />GRAB. <br />EFFLUENT GROSS <br />REQUIREMENT::1 <br />,.. .. <br />PERCENT <br />::::::::::::::::::::::::::::::::::::::::::::::::: <br />........................... <br />SAMPLE <br />MEASUREMENT <br />PFRMr1:::: <br />... <br />. ...:. <br />.,. .; . <br />EQU R <br />. <br />. . . ......... <br />....... <br />. . <br />........................... <br />SAMPLE <br />. . <br />............................ <br />. . . . . . . . . <br />.................... <br />.................... <br />... ........................... <br />....... <br />MEASUREMENT <br />FE .N11T:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: <br />R <br />R ::U fZEMENT! <br />EQ I. <br />': : '' ::: <br />.. <br />.................................................................................................. <br />SAMPLE <br />..................................... <br />.................. <br />MEASUREMENT <br />PMIT:: . <br />...... <br />REQUIREMENT: <br />. . . . . <br />. <br />............ <br />:::: <br />........ <br />.::.REQUIREMENT::* <br />. . . . . . . <br />................ <br />.... <br />SAMPLE <br />. <br />............................ <br />.. <br />.................... <br />MEASUREMENT <br />IRM <br />::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: <br />.: <br />REQUI.. EME....... <br />. <br />................................................................................................. <br />SAMPLE <br />...... <br />..................................... <br />.................. <br />MEASUREMENT <br />pFRMrt .:..: .... <br />REQUIREMENT._ <br />. _...._..__ — . <br />NAME / TITLE PRINCIPAL EXECUTIVE OFFICER <br />TELEPHONE <br />DATE <br />CERTIFY UNDER PENALLY 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 AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION. <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />970-929-5015 <br />1/17/2017 <br />INCLUDING THE POSSIBILITY OF FINE AND IMPRISONMENT FOR KNOWING VIOLATIONS. <br />iMM/DD/YYYY <br />TYPED OR PRINTED OFFICER OR AUTHORIZED AGENT <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) I-orms Dy vvinuowcnem(tUi)oov-Uoao;pinlunu;ve.u;inr <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 />00105/980409-1716 PAGE 1 OF 1 <br />