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PERMITTEE NAME/ADDRESS. <br />NAME: MUUN I AIN CUAL CUMNANY, LLC <br />ADDRESS: WEST ELK MINE <br />b1 /4 HIGHWAY 133 <br />SUMEKSE I CU 81434 <br />FACILITY: WEST ELK MINE <br />LOCATION: APPX 1 MI. E. OF TOWN ON HWY 133 <br />SOMERSET, CO 81434 <br />ATTN: WESTON J. NORRIS, GENERAL MANAGER <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />rOil W CUTE WET TESTING FOR 011A <br />PERMIT NUMBER DISCHARGE NUMBER (SUBR MH) MNTRS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR -11 <br />FROM To NO DISCHARGE <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 />EX <br />OF <br />ANALYSIS <br />TYPE <br />VALUE VALUE UNITSI VALUE VALUE VALUE <br />SAMPLE <br />MEASUREMENT <br />UNIT <br />LC50 STATRE 48HR ACU <br />DAPHNIA MAGNA <br />(23) <br />TAM3C 1 0 <br />EFFLUENT GROSS SEE COMMENTS <br />PERMIT <br />REQUIREMENT NO D <br />SAMPLE <br />MEASUREMENT <br />PERCENT <br />QTRLY <br />GRAB <br />LC50 STATRE 96HR ACU <br />PIMEPHALES <br />(23) <br />TAN6C 1 0 EFFLUENT <br />GROSS <br />PERMIT <br />REQUIREMENT <br />PERCENT <br />CITRLY <br />GRAS <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />ICE P,FF UNOER PENALTY OF LAW THAT THIS DOCUMENT AND ALL ATTACHMENTS WERE PREPARED UNDER MV <br />DIRECTION OR SUPERVISION IN ACCORDANCE WITH A SYSTEM DESIGNED TO ASSURE THAT QUALIFIED PERSONNEL <br />TELEPHONE <br />DATE <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 THE <br />INFORMATION, THE INFORMATION SUBMITTED IS, TO THE BEST OF MY KNOWLEDGE AND BELIEF, TRUE, ACCURATE, <br />John Poulos AND COMPLETE I AM AWARE THAT THERE ARE SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION, SIGNATURE OF PRINCIPAL EXECUTIVE <br />INCLUDING THE POSSIBI LITV OF FINE AND IMPRISONMENT FOR KNOWING VIOLATIONS. <br />970-929-5015 <br />1/8/2019 <br />TYPED OR PRINTED OFFICER OR AUTHORIZED AGENT <br />I MM/DD/YYYY <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) Forms by WindowChem(70n864-0845;p/n11090,V5.0;1/IM <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 />