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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 (NIDDES) <br />DISCHARGE MONITORING REPORT {DMR) <br />C00038776 004 W _-JACUTE WET TESTING FOR 004A <br />PERMIT NUMBER DISCHARGE NUMBER] (SUB R MH) GUNIS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />FROM I 1/112U1 ( _j TO 1 31111201 NO DISCHARGE r X <br />NOTE: Read instructions before completing this form. <br />PARAMETER <br />QUALITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />FREQUENCY <br />SAMPLE <br />VALUE VALUE UNITS <br />>< <br />EX <br />OF <br />ANALYSIS <br />TYPE <br />VALUE _T <br />VALUE <br />VALUE <br />UNIT <br />LC50 STATRE 48HR ACU <br />DAPHNIA MAGNA <br />SAMPLE <br />MEASUREMENT <br />(23) <br />1/90 <br />GRAB <br />TAM3C 1 0 <br />EFFLUENT GROSS SEE COMMENTS <br />PERCENT <br />:R <br />N,�:-` <br />...... <br />LC50 STATRE 95HRACU <br />PIMEPHALES <br />SAMPLE <br />MEASUREMENT <br />(23) <br />1/90 <br />GRAB <br />TAN6C 1 0 <br />EFFLUENT GROSS SEE COMMENTS <br />N O DISCHARGE <br />PERCENT <br />7 i: - <br />......... <br />F.T <br />:::.::::::::..::::::::::::: <br />Did effluent consist of surface <br />SAMPLEMEASUREMENT <br />water only for the entire <br />quarter? <br />NAME TITLE PRINCIPAL EXECUTIVE OFFICER -TELEPHONE <br />DATE <br />412812017 <br />ICERTIFY 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 EVALUATE THE INFORMATION SUBMITTED. EASED ON MY INQUIRY OF THE PERSON OR I <br />PERSONS WHO MANAGE THE SYSTEM, M THOSE PERSONS DIRECTLY RESPONSIBLE FOR GATHERING THE <br />INFORMATION. THE INFORMATION SUBMITTED 13, TO THE BEST OF My KNOWLEDGE AND BELIEF. TRUE ACCURATE <br />AND COMPLETE I AM AWARE THAT THERE ARE SIGNIFICANT PENALTIES FOR 5 G FALSE INFORMATION <br />Weston Norris INCLUDING THE POSGIBILITY OF FINEAND IMPRISONMIENT FOR KNOWINGOOLATIONS"' SIGNATURE OF PRINCIPAL EXECUTIVE 970-929-5015 <br />OFFICER OR AUTHORIZED AGENT <br />TYPED OR PRINTED <br />MWDD/YYYY <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) FOFDH by WindowChem(7D7)864-0545;ptnII090v5 O;1M= <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 />000171980409-1716 PAGE 1 OF 1 <br />