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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 />/11 1 IN. JIIVI U. IVIILLCR, VCIVCI�/iL IVI/11V/1VCR <br />PARAMETER <br />LC50 STATRE 48HR ACU <br />SAMPLE <br />DAPHNIA MAGNA <br />MEASUREMENT <br />TAM3C 1 0 <br />PFCVIET; <br />EFFLUENT GROSS SEE COMMENTS <br />; ;lf�4UiREMENT:.; <br />LC50 STATRE 96HR ACU <br />SAMPLE <br />PIMEPHALES <br />MEASUREMENT. <br />TAN6C 1 0 <br />EFFLUENT GROSS <br />REQUIREMENT <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />C00038776 011 W ACUTE WET TESTING FOR 011A <br />PERMIT NUMBER DISCHARGE NUMBER (SUER MH) MNTRS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />FROM TO NO DISCHARGE <br />IVV I t: Keaa InSTfUCTIOnS DeTOre COD1pieung TRIS Torm. <br />QUALITY OR LOADING QUALITY OR CONCENTRATION <br />NO. FREQUENCY SAMPLE <br />VALUE VALUE UNITS VALUE VALUE j VALUE UNIT EX OF TYPE <br />ANALYSIS <br />(23) <br />NO DISCHARGE <br />SAMPLE <br />MEASUREMENT <br />PERMR <br />REQUIREMENT: <br />. .... .... .... <br />................................... <br />SAMPLE <br />MEASUREMENT <br />PERCENT... <br />(23) <br />OTRLY GRAA; <br />PERCENT :::::::::::::::::::::::::::::::::::::::::::: <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 />00105/980409-1716 PAGE 1 OF 1 <br />PERMIT ...... <br />. <br />... <br />REQUIREMENT. <br />. <br />.... <br />..... . <br />SAMPLE <br />............ <br />..................................... <br />.................. ................... <br />.......... ....... <br />MEASUREMENT <br />R' <br />PE . MB ... <br />...:. <br />1 N <br />R> QU REMEi T <br />SAMPLE <br />..................... <br />................................. <br />............. ....... ........ <br />.... ......... ..... <br />............... <br />MEASUREMENT <br />P iT::::::::::::: <br />M... . <br />::::::::::::.:::::: <br />I.:...{Vl::::::::::::::::::::::::::::::::::::::: <br />':;'::;:;:::;:::::;:::;:;:;:::;:;:;:;:; <br />.:::.:...........:.:......................:...:.:.:...........:.:.:....:.......:.:.:.....:.:.:.:.:.::.. <br />.:. <br />.:: ..:. <br />.:.. <br />. <br />... .. <br />. <br />.......................................................................................................... <br />SAMPLE <br />MEASUREMENT <br />R <br />PE::::::::::::::::::::::::: <br />is <br />:REQU REMENT:::: <br />:::::::::; <br />NAME ! TITLE PRINCIPAL EXECUTIVE OFFICER <br />1 <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 />I <br />I <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 OR, <br />- <br />4, <br />Weston NorrisAND <br />! INFORMATION, THE INFORMATION SUBMITTED IS, TO THE BEST OF MY KNOWLEDGE AND BELIEF, TRUE, ACCURATE, <br />COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION,. <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />970-929-5015 <br />7/6/2017 <br />1 INCLUDING THE POSSIBILITY OF FINE AND IMPRISONMENT FOR KNOWING VIOLATIONS. <br />TYPED OR PRINTED <br />OFFICER OR AUTHORIZED AGENT <br />MM/DD/YYYY <br />r'nAAfLACA1T ANIM CVO. AKIATInAI nc Anly Xnr"I ATIr"KIC <br />Forms by WindowChem(707)864-0845;p/n11090;v5.0;1/N96 <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 />00105/980409-1716 PAGE 1 OF 1 <br />