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PERMITTEE NAME/ADDRESS (Include Facility Nama/Location J Different) <br />NAME: Moffat County Mining LLC <br />ADDRESS: 29515 Routt CR 27 <br />Oak Creek, CO 80467-9704 <br />FACILITY: WILLIAMS FORK MINE <br />LOCATION: 1030 CR 107 <br />CRAIG, CO 81626 <br />ATTN: Jerry Nettleton, Supv <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />000034142 003-X <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM/DD/YYYY MM/DD/YYYY <br />1 /1/20TV 12/31/201V <br />DMR Mailing ZIP CODE: <br />MINOR <br />Chronic WET Testing at 003A <br />External Outfall <br />Form Approved <br />OMB No. 2040-0004 <br />80467-9704 <br />No Discharge rM <br />PARAMETER <br />QUANTITY OR LOADING <br />VALUE VALUE UNITS <br />QUALITY OR CONCENTRATION <br />NO. <br />EX <br />FREQUENCY <br />OF ANALYSIS <br />SAMPLE <br />TYPE <br />VALUE <br />VALUE <br />VALUE <br />UNITS <br />%Effect Statre 7Day Chronic <br />Pfinephales <br />TCP6C S 0 <br />See Comments <br />SAMPLE '•'"" <br />MEASUREMENT <br />"'•" <br />•..... <br />CCS f ` 1 1 <br />"•"' <br />e'••" <br />AUTHORIZED AGENT <br />PERMIT •••»• <br />REQUIREMENT <br />••»» <br />••»» <br />18 <br />MN VALUE <br />•••••• <br />"•"""" <br />% <br />Annual <br />GRAB -3 <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER <br />I rsfy°"dape"WtyW°wthat u,Isa MUN..eaa111MI tsa—aPnpokd.ndmmydbs—a <br />TELEPHONE <br />DATE <br />sapemabn In ..d— -h s syetam daslgned to Sumo that M MMM penonn.i pa dy gath.e end <br />elms ate Intonmtlpn aumMttM eased - my inq Aq o/ pu penin. p.—. — —.p tho <br />syst m of those pitons dhactly nspeh tiW6 for gaewmg Me h fmn%" n the kftr tloaw <br />n mltM Is <br />W Ne b..& my la—.4.d" and beiNf has, —at... W wmpteu 1 am — tMt tlwn <br />V <br />iii <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />CCS f ` 1 1 <br />sIgnmunt pan.lues fm mwatthti Was Iniamadon m k.w,g me ppas"tya fma end imp ,pant fm <br />AUTHORIZED AGENT <br />TYPED OR PRINTED <br />eller, code NUMBER <br />MM/Dp/YYYY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SEE I.B.3. FOR DETAILS OF TEST PROCEDURE. RPT RESULTS OF LETHALITY OERIVS AS *% EFFECT". GROWTHBREPRODDERIVS AS "TOXICITY". RPT LOWEST % EFFL AT WHICH <br />STATISTICALLY SIGNTFDTFP WAS OBSERVED USING CODE "S".RPT IC25 USING CODE "P". IWC=18%. ATTACH TOX REPORT FORM TO DMR. <br />EPA Form 3320.1 (Rev.01/06) Previous editions may be used. 05/08/2013 Page 2 <br />