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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 016 W ACUTE WET TESTING FOR 016A <br />PERMIT NUMBER DISCHARGE NUMBER (SUBR MH) GUNIS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />FROM To NO DISCHARGE <br />A I I N: KtNNt I H UUUHKAN, <br />h'Kt51UtN I IVU I t: Keaa Instructions Detore completing <br />mIS Torm. <br />QUALITY OR LOADING <br />QUALITY OR CONCENTRATION <br />PARAMETER <br />...... <br />. . . . . ................. <br />NO. <br />FREQUENCY <br />SAMPLE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNIT <br />>< <br />EX <br />OF <br />ANALYSIS <br />TYPE <br />LC50 STATRE 48HR ACU <br />SAMPLE <br />(23) <br />........... <br />................................... <br />DAPHNIA MAGNA <br />MEASUREMENT <br />PRNIIT;;;; <br />............................ <br />QTRLY. <br />TAM3C 1 0 <br />EFFLUENT GROSS SEE COMMENTS <br />REQUIREMENT:; <br />:::....N . <br />i <br />j <br />PERCENT;:;:; <br />; :::::;:....::;:... <br />..CRAB.. . <br />;:;:::::::::::::.. . <br />LC50 STATRE 96HR ACU <br />SAMPLE <br />(23) <br />... <br />PIMEPHALES <br />MEASUREMENT <br />TAN6C 1 0 <br />pET <br />NO D <br />. . <br />EFFLUENT GROSS <br />REQUIREMENT:::::Q:::T::R:::i: <br />............................ <br />PERCENT <br />::Y::::: <br />..::G::::R::::4::B::::::. <br />SAMPLE <br />......... <br />Did effluent consist of surface <br />MEASUREMENT <br />water only for the entire <br />MEASUREMENT <br />P6RMri :::: <br />quarter? <br />REQ iREMENT <br />' <br />PFTMIT: <br />SAMPLE <br />MEASUREMENT <br />.. . <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />F't RM[7 <br />TELEPHONE <br />DATE <br />I CERTIFY UNDER PENALTY OF LAW THAT THIS DOCUMENT AND ALL ATTACHMENTS WERE PREPARED UNDER MY'. <br />REQUIREME....._. <br />DIRECTION OR SUPERVISION IN ACCORDANCE WITH A SYSTEM DESIGNED TO ASSURE THAT QUALIFIED PERSONNEL <br />.;. .: .. <br />SAMPLE <br />PERSONS WHO MANAGE THE SYSTEM, OR THOSE PERSONS DIRECTLY RESPONSIBLE FOR GATHERING THE <br />MEASUREMENT <br />Weston Norris <br />INFORMATION, THE INFORMATION SUBMITTED IS, TO THE BEST OF MY KNOWLEDGE AND BELIEF, TRUE, ACCURATE, <br />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 />SEE I.A.5, PP- 6-7, FOR DETAILS OF TEST PROCEDURE. LC50- STATISTICAL POINT ESTIMATE WHICH IS LETHAL TO 50% TEST ORGANISMS, AND ATTACH ACUTE TOXICITY TEST REPORT FORM <br />TO DMR. WET TESTING IS NOT REQUIRED WHEN DISCHARGE DOES NOT CONTAIN ANY MINE WATER FOR THE ENTIRE CALENDAR QUARTER. SEE I.A.a, PP3 - ALTERNATE LIMITATIONS. <br />00121/980409-1716 PAGE 1 OF 1 <br />phlMrl............... <br />......... <br />...... <br />. . . . . ................. <br />R: :;i:: <br />E U MENT::::::::::::: <br />Q RE <br />::::::::::::::: <br />SAMPLE <br />........... <br />................................... <br />MEASUREMENT <br />... <br />. <br />.... <br />REQU,IREME. T.. <br />........ ........... <br />. . <br />.: <br />........................................................... <br />SAMPLE <br />......... <br />.................. <br />MEASUREMENT <br />PFTMIT: <br />.. <br />:,REG UIf2ElUlENT :::: <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 />Weston Norris <br />INFORMATION, THE INFORMATION SUBMITTED IS, TO THE BEST OF MY KNOWLEDGE AND BELIEF, TRUE, ACCURATE, <br />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 />TYPED OR PRINTED <br />OFFICER OR AUTHORIZED AGENT <br />MM/DD/YYYY <br />..'.,, ...,—.,-,- ,. ,,,-, �",-„ ,, .,-,-„-,,, ,-„— <br />,. .,.. ..,..,-,.-..,.. ,.,_,.. _ _,. _.,__,_____•_ ,____, <br />Forms by WindowChem(707)864-0845;P/n11090;v5.0;1/1/96 <br />SEE I.A.5, PP- 6-7, FOR DETAILS OF TEST PROCEDURE. LC50- STATISTICAL POINT ESTIMATE WHICH IS LETHAL TO 50% TEST ORGANISMS, AND ATTACH ACUTE TOXICITY TEST REPORT FORM <br />TO DMR. WET TESTING IS NOT REQUIRED WHEN DISCHARGE DOES NOT CONTAIN ANY MINE WATER FOR THE ENTIRE CALENDAR QUARTER. SEE I.A.a, PP3 - ALTERNATE LIMITATIONS. <br />00121/980409-1716 PAGE 1 OF 1 <br />