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PERMITTEE NAME/ADDRESS <br />NAME: MOUNTAIN COAL COMPANY, 111C <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, PRESID NT. <br />PARAMETER <br />OIL AND GREASE <br />VISUAL <br />84066 1 0 <br />EFFLUENT GROSS <br />VALUE <br />:::::R!E:RMIT <br />2EQUIREiME <br />SAMPLE <br />SAMPLE <br />MEASUREMI <br />MEASU <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />0038776 015 SURFACE RUNOFF TO N FK GUNNISON R <br />PERMIT NUMBER DISCHARGE NUMBER (SUBR MH) GUNIS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD MINOR <br />FROM TO NO DISCHARGE ET] <br />NOTE: Read instructions before completing this form. <br />LITY OR LOADING QUALITY OR CONCENTRATION <br />NO. FREQUENCY SAMPLE <br />VALUE UNITS VALUE VALUE VALUE UNIT EX OF TYPE <br />ANALYSIS <br />NO DISCHARGE <br />:::F?ERMIT:N <br />E2EQUIREM h.T I I <br />SAMPLE <br />ONCE1 <br />*+ « r:VISUA <br />MC33?iTH <br />:R [ <br />EQU aE <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER +}+} GERtIFY VNDER PENALTY OF LAW THAT THIS DOCUMENT AND ALL AFIACHMFNTS WERE PREPARED UNDER NIY ? TELEPHONE D A T E <br />IRECf10N OR SUPERVISION IN ACCORDANCE WITH A SYSTEM 1)111-- TO ASSURE THAT QUALIFIED PERSONNEL? / <br />ROPENLY GATHER AND EVALUATE THE INFORMATION SUBMITTED. BASED ON MY INQUIRY OF THE PERSON OR PERSONS <br />10 MANAGE THE SYSTEM, OR THOSE PERSONS UIREUTLY RESPONSIBLE FOR GATHEWNG TIIE INFORMATION, TIIEI <br />FORMATION SUBMITTED IS, TO THE BEST OF MY KNOWLEDUE AND BELIEF, TRUE, ACCUR4TF, AND CONB'LETE. 1 Al," Doug Nolte WARE THAT THERE ARE SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INF0R4NTION.INCLUDING <br /> THEPOSSIBILITY OFj SIGNA?EIR EOFPRINCIPALEXECUTIVE 970929-5015 1/8/2010 <br />PINE AND IMPRISONMENT FOR KNOWING VIOLATIONS. <br />TYPED OR PRINTED II OF OR AUTHORIZED AGENT AREA CODE NUMBER MM/DD <br />M'YY <br />COMMENT AND EXPLANATION OF ANY VIOLATIO S (Reference all attachments here) Foams by W1ndOWCheD(707)864-0845;plnl1090;V5.0;1n196 <br />TSS & TOTAL IRON LIMITS WILL BE WAIVED, AN 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 1.B.1.F. <br />00170/980409-1716 PAGE 2 OF 2