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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 />ATTN: KENNETH COCHRAN, PRESIDENT <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />C00038776 005 A COAL CONVEYOR RUNOFF (MB -3) <br />PERMIT NUMBER DISCHARGE NUMBER (SUER MH) MNTRS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />FROM To NO DISCHARGE <br />NOTE: Read instructions before completing this form. <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) Forms by VVmdowChem(707)884-0845;pIn11090;v5.0;1/1196 <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.15. <br />00025/980409-1716 PAGE 1 OF 2 <br />QUALITY OR LOADING <br />QUALITY OR CONCENTRATION <br />PARAMETER <br />NO. <br />FREQUENCY <br />SAMPLE <br />>< <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNIT <br />EX <br />OF <br />TYPE <br />ANALYSIS <br />SAMPLE <br />PH MEASUREMENT <br />(12) <br />00400 1 0 PEF?NlET <br />OiVC) <br />EFFLUENT GROSS..REQUIREMENT.S. <br />U. <br />[MONTH :::::i::::::;:;:;: <br />INS t711:::: <br />: <br />SOLIDS, TOTAL SAMPLE <br />SUSPENDED MEASUREMENT <br />(19) <br />00530 1 0 Pt fiM(T <br />ONCE:/: <br />EFFLUENT GROSS REQUIREMENT ! <br />mg/I <br />MpNTH..' <br />.GRAB <br />SOLIDS, SETTLEABLE SAMPLE <br />MEASUREMENT <br />(25) <br />00545 1 0 }'EF?(v1ET <br />ONC <br />REQUIREMENT.; , <br />EFFLUENT GROSS <br />mg/I <br />ONTH..: <br />CxfZA6 <br />IRON, TOTAL SAMPLE <br />(AS FE) MEASUREMENT <br />(28) <br />o>lMT; <br />: <br />:01045 <br />1 0 <br />NO DISCHARGE9/I <br />GROSS REQUIREMENT <br />... <br />..................... <br />............... <br />NONH::: <br />:..:;.:' <br />: :.: : ::EFFLUENT <br />: <br />SAMPLE <br />OIL AND GREASE MEASUREMENT <br />(19) <br />03582 1 0EFFLUENT <br />GROSS REQUIREMENT:: <br />G <br />::GRAB:* <br />........:: <br />.mg/I <br />FLOW, IN CONDUIT OR SAMPLE <br />THRU TREATMENT PLANT MEASUREMENT <br />50050 1 0 I?EtN1fT <br />NG) <br />EFFLUENT GROSS REQUIREMENT:: <br />.............. ................. <br />MON1 H_:_:: <br />::I:NSTANT: <br />SOLIDS, TOTAL SAMPLE <br />DISSOLVED MEASUREMENT <br />(19) <br />70295 1 0 PtMET <br />EFFLUENT GROSS REQUIREMENT:: <br />mg/I <br />...... <br />. C..�.. <br />TELEPHONE <br />DATE <br />NAME / TITLE PRINCIPAL EXECUTIVE OFFICER <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 />MY INQUIRY OR <br />PROPERLY GATHER AND EVALUATE THE INFORMATION SUBMITTED. BASED ON OF THE PERSON <br />PERSONS WHO MANAGE THE SYSTEM. OR THOSE PERSONS DIRECTLY RESPONSIBLE FOR GATHERING THE <br />ACCURATE <br />Weston Norris AND COMPLETE.H NFORMATION I IAM AWARE THAT THERE ARE SIGNIFICANT PENALTIES FOR SUBMITTING FALSENFORMATION, SUBMITTED IS. TO THE BEST OF MY KNOWLEDGE AND BELIEF,UINFORMATION: SIGNATURE OF PRINCIPAL EXECUTIVE <br />INCLUDING THE POSSIBILITY OF FINE AND IMPRISONMENT FOR KNOWING VIOLATIONS. <br />970-929-5015 <br />1/17/2017 <br />TYPED OR PRINTED OFFICER OR AUTHORIZED AGENT <br />MM/DD/YYYY <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) Forms by VVmdowChem(707)884-0845;pIn11090;v5.0;1/1196 <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.15. <br />00025/980409-1716 PAGE 1 OF 2 <br />