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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 004 A POND MB -2R (BACKWASH & RUNOFF) <br />PERMIT NUMBER DISCHARGE NUMBER (SUBR MH) MNTRS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />FROM To NO DISCHARGE 0 <br />MI I IV: JIIVI U. IVIILLtK, UtNtzKAL IVIANAUt:N NOTE: Read instructions before completing this form. <br />QUALITY OR LOADING <br />QUALITY OR CONCENTRATION <br />PARAMETER <br />NO. <br />FREQUENCY <br />SAMPLE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNIT <br />EX <br />OF <br />TYPE <br />ANALYSIS <br />SOLIDS, TOTAL <br />SAMPLE <br />MEASUREMENT <br />1 <br />1/90 <br />GRAB <br />DISSOLVED <br />(19) <br />70295 1 0 <br />PRMi.T <br />EFFLUENT GROSS <br />R 4UIRENIENT <br />NO D <br />mg/I <br />QTRLY ` <br />`''' R�#�; <br />OIL AND GREASE <br />SAMPLE <br />VISUAL <br />MEASUREMENT <br />NA <br />NA <br />84066 1 0 <br />REQUIREMENT <br />WEEKLY <br />VISUAL:. <br />EFFLUENT GROSS <br />: <br />SAMPLE <br />MEASUREMENT <br />.: <br />REQEIIREMENT` <br />. <br />....................................................................................... <br />SAMPLE <br />. ............ . <br />MEASUREMENT <br />P IT <br />1 RAtI...... <br />.::::::::::::::::::::::::::::::::: <br />f.... NT <br />:::::::::: <br />:::::'::' :::::::::': <br />SAMPLE <br />MEASUREMENT <br />R f....::::..........:::::...........::::.....::..:::::............::::........:.:::: <br />............................... <br />R. <br />4.... M .. T.. <br />........ <br />SAMPLE <br />MEASUREMENT <br />1?f7 <br />t FiM <br />:::::::::::::::::::::::::::::::::::::::::::::::: <br />R.... ; T :::::::::::::::: <br />E2EQUI . EMEN.... <br />. <br />:::::::::: ::::::' <br />SAMPLE <br />.......................................................... <br />MEASUREMENT <br />R <br />::':::'::::':::':::::::::: <br />is REM <br />RIr4 E EJ N f <br />E <br />NAME / TITLE PRINCIPAL EXECUTIVE <br />OFFICER <br />I <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 PERSONNE <br />PROPERLY <br />Weston Norris <br />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 />INFORMATION, THE INFORMATION SUBMITTED IS, TO THE BEST OF MY KNOWLEDGE AND BELIEF, TRUE, ACCURATE, <br />IAND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION,: <br />INCLUDING THE POSSIBILITY OF FINE AND IMPRISONMENT FOR KNOWING VIOLATIONS. <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />970-929-5015 <br />° <br />7/6/2017 <br />TYPED OR PRINTED <br />OFFICER OR AUTHORIZED AGENT <br />MM/DD/YYYY <br />Cn8A8AFAIT AAIr) GYDI AAIATInAI nC <br />AAIV N/In1 ATInAIC <br />Forms by WindowChem(707)864-0845;p/711000;v5.0;1/T/86 <br />TSS & TOTAL IRON LIMITS WILL BE WAIVED, AND SETTLEABLE SOLIDS LIMIT APPLIED FOR < 10YR, 24HR PRECIP EVENT -SEE I.A.2, 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 I.B.1.F. <br />00002/980409-1716 PAGE 2 OF 2 <br />