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PERMITTEE NAME/ADDRESS: <br />NAME: <br />MOUNTAIN COAL COMPANY, LLC <br />ADDRESS: <br />WEST ELK MINE <br />QUALITY OR LOADING <br />5174 HIGHWAY 133 <br />SOMERSET CO 81434 <br />FACILITY: <br />WEST ELK MINE <br />LOCATION: <br />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 014 A SURFACE RUNOFF TO SYLV. GULCH <br />PERMIT NUMBER DISCHARGE NUMBER (SUBR MH) GUNIS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />FROM To NO DISCHARGE FXJ <br />Al I N: KENNE I H GUGHKAN, <br />NKE5IUEN I NU I t: Keaa Instructions Detore completing <br />inIS Torm. <br />QUALITY OR LOADING <br />QUALITY OR CONCENTRATION <br />PARAMETER <br />NO. <br />FREQUENCY <br />SAMPLE <br />EX <br />OF <br />ANALYSIS <br />TYPE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNIT <br />OIL AND GREASE <br />SAMPLE <br />!?::. <br />................... <br />1/30 <br />VISUAL <br />VISUAL <br />MEASUREMENT <br />**** <br />84066 1 0 <br />I'EfMIT <br />::::::....... ::'... <br />17N <br />::: <br />EFFLUENT GROSS <br />REQUIREMENT <br />NO D <br />**** <br />E:::MOIqTH::::::::: <br />V ISUAL;:; <br />............................................................................. <br />SAMPLE <br />SAMPLE <br />MEASUREMENT! <br />MEASUREMENT <br />::::::::p MITr , <br />::::R EQUIRE* MENT <br />VVIVIIVILIVI (l1V✓L/�r Lfll VfllIVIY VI lllVl VIVLfl11VIYV II\cl cl cl/l.c Plr PllPl.11lllclll.11cl c� <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 />00154/980409-1716 PAGE 2 OF 2 <br />SAMPLE <br />MEASUREMENT <br />l <br />ER T <br />P.M ........................ <br />:::::::::: ! !......:::::::::::::::::: <br />!?::. <br />................... <br />.............. <br />................... <br />..............,........................ <br />.REQUIREMENT:.... <br />:::::::::::::::: <br />::::::....... ::'... <br />............................................................................. <br />SAMPLE <br />MEASUREMENT <br />P .NIT ::::::::: <br />tR I <br />::::: .:::: <br />::::::::: <br />U E 'ENT:' <br />F21iQ I . EM <br />::::::::: : :!:: :: ` <br />::'. . <br />SAMPLE <br />............. <br />.................. <br />MEASUREMENT <br />::::::::::::::::::::::::::::::::::::::::::::::: <br />PF.M T ....................... <br />UI . EMENT ::: <br />E3. Q........... <br />l l l l <br />.::. .. . <br />.:.:...:::::..:... . <br />.. .......... . <br />SAMPLE <br />...................... <br />................... <br />..................................... <br />MEASUREMENT <br />P (7 <br />SRM <br />:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: <br />RI QWIREMEN.... <br />SAMPLE <br />..................................... <br />................. <br />MEASUREMENT <br />.:. R :::::::::::::':: <br />I ... <br />.:.:.:.:..:.:.: . . <br />REG2EJIREMENT.: <br />........... <br />NAME / TITLE PRINCIPAL EXECUTIVE OFFICER <br />................... .......:.:.:.:.:.:.:.:.:.:.:.:..:.:.:.:.:.:.:.:.:...:...:..:....:...:.................................................................. <br />TELEPHONE <br />DATE <br />1 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 />Weston Norris <br />INFORMATION, THE INFORMATION SUBMITTED IS, TO THE BEST OF MY KNOWLEDGE AND BELIEF, TRUE, ACCURATE, <br />AND COMPLETE. 1 AM AWARE THAT THERE ARE SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION, <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />970-929-5015 <br />i <br />1/17/2017 <br />INCLUDING THE POSSIBILITY OF FINE AND IMPRISONMENT FOR KNOWING VIOLATIONS. <br />I <br />TYPED OR PRINTED <br />i OFFICER OR AUTHORIZED AGENT <br />IMM/DD/YYYY <br />.,.... .. ..—..-.- ...., .—...,. . , ..-.-..... ., .— <br />.. �... ,.... .--.....,. <br />Forms by WindowChem(767)864-6845;p/n71090;v5.6;l/l/96 <br />VVIVIIVILIVI (l1V✓L/�r Lfll VfllIVIY VI lllVl VIVLfl11VIYV II\cl cl cl/l.c Plr PllPl.11lllclll.11cl c� <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 />00154/980409-1716 PAGE 2 OF 2 <br />