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t'LHA9! I TEE NAMUADURLSS. <br />NAME: MOUNTAIN COAL COMPANY. LLC <br />ADDRESS: WEST ELK MINE <br />P.O. BOX 591 <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: EUGENE E. DICLAUDIO, PRESIDENT <br />NATIONAL I'UL'JIAN; DISCIIARGL LUMINATION SYSTEM fNPULSJ <br />DISCHARGE MONITORING REPORT (DMR) <br />(004 W ACUTE WET TESTING FOR 004A <br />PERMIT NUMBER DISCHARGE NUMBER (SUER MH) GUNIS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />FROM 091 01 101 TO 09 1 03 1 31 NO DISCHARGE Q <br />NOTE Read instructions before completmq this form <br /> QUALITY OR LOADING QUALITY OR CONCENTRATION <br />PARAMETER NO FREQUENCY SAMPLE <br /> VALUE VALUE UNITS VALUE VALUE VALUE UNIT EX or TYPE <br /> ANALYSIS <br />LC50 STATRE 48HR ACU SAMPLE # <br /># <br />" ** <br />**** *#w***** *******w <br /> <br />Mf?;iUI2EMErdT <br />R <br />*** <br />' <br />* <br />* <br />(23) <br />0 ••• A\# <br />DAPHNIA MAGNA <br />TAM3C 1 0 0 PERMIT 100.OOD1 <br /> <br />EFFLUENT GROSS <br />REOUIREMEN f #*****## <br />MN VALUE *##***** ,**+*,,, <br />PERCENT <br />OTRLY <br />GRAB <br />LC50 STATRE 96HR ACU LANIPLL <br /> <br />MEASUREMENT <br />(23) <br />0 _•• •. <br />PIMEPHALES <br />TAN6C 1 U PERMIT 100.0001 <br />*#R#*##* <br />?`""*"* <br />EFFLUENT GROSS SEE COMMENTS REQUIREMENT ••*+++*• ******** MN VALUE PERCENT OTRLY GRAB <br /> SAMPLE <br />DID EFFLUENT CONSIST OF <br />6AGASUREMENT 1 <br /> <br />SURFACE WATER ONLY FOR THE YES=1 <br /> PERMIT NO=0 <br />ENTITRE QUARTERS <br /> REQUIR[MrrtT <br /> <br /> <br /> <br /> <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER TELEPHONE D A T E <br />gal .•? I 1' 1 { I <br />I I MEN 1 N W1. .'MINX AI /1 / <br />- '• i t 1' I l 11\1 V . 1.1 x11,1.111 Ill AIJIIrU M:0.M 111N <br />il <br />/ <br />- <br />E\ <br />\I <br />I/` <br />\ <br />. <br />// <br />.1'IX .111 ' 11 '\II Y 1, 11 F Mllr 1iJl -,,t U IIh AI\ IM/110.1 llr itlr R.XG 1N rrw%, hi <br />,,r AI V i lltl xrt11. ,•X Illllyt poll." IIIX HA MI.\M htilll 1. 111N IIAlII1 XINl1 ML INIIINAI111r1N I'll' <br />. X10.11 •? it'.1\"I Ill! :\. Ill II1L III.\I ." ,, ".-r- "" J."L <br />INI <br />Haul\0.Lq,.}IIIC.\\-rrr,mrIL,NINO0.Nllrlr`T•r,UFElkinlU?tAr11M.IfKL1mm;lurnlzzuulJnlrl SIGN UREOFPRINCIPALEXECUTIVE <br />Doug Nolte °° N? r,I.IN=I,rgl.\IIHI„1\luI.AIIr111F 970 929-5015 09 04 1 20 <br />OFFICER OR AUTHORIZED AGENT <br />TYPED OR PRINTL-D ARrACOUeNUMBER YEAR MO DAY <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS <br />(Reference all attachments here) <br />SEE I.A.5, PP- 6-7, FOR DETAILS OF TEST PROCEDURE LC50- STATISTICAL POINT ESTIMATE WHICH IS LETHAL TO 50% TEST ORGANISMS, AND ATTACH ACUTE TOXICITY TEST REPORT FORM TC <br />DMR. WET TESTING IS NOT REQUIRED WHEN DISCHARGE CONSISTS ENTIRELY OF SURFACE RUNOFF WATER FOR THE ENTIRE CALENDAR QUARTER SEE I A a PP3 - ALT 1/1512009 <br />000171980409-17 16 PAGE 1 OF 1