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DocuSign Envelope ID: D07924E6-3D94-4398-A066-B683COBAB33E <br /> PERMIT NARRATIVE CONDITIONS REPORT FORM (continued) <br /> PART C. FACILITY/PROJECT INFORMATION <br /> Facility/Project Name Colowyo Coal Mine <br /> Location (address) 5731 State Highway 13 <br /> City Meeker County Moffat & Rio Blanco <br /> Chantell Johnson Phone 303.254.3185 office or 303.482.6219 cell <br /> Local Contact Name Number <br /> Title Senior Environmental Planner Email cjohnson@tristategt.org <br /> PART D. CONTENTS AND PURPOSE OF SUBMISSION <br /> 1. What is the nature of the attached document? <br /> Status Report❑✓ <br /> Mixing Zone Stu y❑ <br /> Tracer Study❑d <br /> Sediment Control Plan.❑ <br /> Documentati f Installation of Temperature Monitoring Equipment❑ <br /> Salinity Study <br /> Inflow/Infiltration Study❑ <br /> 85 Percent Removal U/ iver Report❑ <br /> Groundwater Study <br /> Seepage Rate Study <br /> Other (please describe) <br /> 2. Is this document submitted to comply with a compliance schedule in your permit? YES❑✓ NO[:] <br /> 3. If this is a compliance schedule document, please answer the following: <br /> a. What is the name or description of the compliance schedule? (For example,Activities to Meet <br /> Total Ammonia Final Limits) <br /> Activities to Meet Final Chronic WET (C. dubia and P. promelas) Limits (outfall 010) <br /> b. What is the "code" in the compliance schedule chart for this item CS010 <br /> Page 2 of 3 June 2019 <br />