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NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) MINOR Form Approved <br />PERMITTEE NAMEIADDRESS (includes Facility NamelLocation if Different) DISCHARGE MONITORING REPORT (DMR) (SUBR JC) OMB No. 2040-0004 <br />F - FINAL MOFFAT <br />NAME BTU EMPIRE CORPORATION - EAGLE MINE COMPLEX NO. 5 MINE TO/WILLIAMS FK <br />ADDRESS 29515 RCR #27 000034142 Q03 A Check here if No Discharge <br />OAK CREEK, CO 80467 PERMIT NUMBER DISCHARGE NUMBER <br />FACILITY LOCATION CRAIG, CO NOTE: Read Instmrtinns helots em-letinn this form <br />ATTN: Mr. Jerry Nettleton, Environmental Supervisor <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />10 07 O1 TO 10 09 Art <br /> QUALITY OR LOADING QUALITY OR CONCENTRATION FREQUENCY SAMPLE <br />PARAMETER <br /> NO. OF TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX ANALYSIS <br />OIL AND GREASE SAMPLE .....+ (94) "+"«+ .. +... ...„. <br />VISUAL MEASUREMENT O O 1I7 VISUAL <br />84066 1 0 0 PERMIT ...... REPORT YES = 1 "«'.. •' "`• I •'».. »+` <br />EFFLUENT GROSS VALUE REQUIREMENT INST MAX NO=O .... WEEKLY VISUAL <br /> SAMPLE ...... ....., +,,,+, „ «+++ ...+.. <br /> MEASUREMENT <br /> PERMIT ,,•`•' «..+.. +.+«.. +..... +« «„ <br /> REQUIREMENT <br /> SAMPLE ..+..+ ...... <br /> MEASUREMENT <br /> PERMIT ...... ...... ...... ...... ., ..« I ...... <br /> REQUIREMENT <br />i <br /> SAMPLE +..... ...... ...... <br /> MEASUREMENT <br /> PERMIT ....+. +«... +...., ...... <br /> REQUIREMENT <br /> SAMPLE `•".. +..... .....« .+ ,... <br /> MEASUREMENT <br /> PERMIT ...•.. ...... ,..+.+ .,.,... +. ,,.. <br /> REQUIREMENT <br /> SAMPLE ...... ...,.. ( 03) ,...,. ...... <br /> MEASUREMENT <br /> PERMIT ...... +..... MGD ,...«. ....,. ,,..,+ <br /> REQUIREMENT. <br />I <br /> SAMPLE ...••• .+++., «..+» .. ««.. ..».. <br /> MEASUREMENT <br /> PERMIT - +...++ ..,.... ..+.,+ «...+. .,«... <br /> REQUIREMENT - <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I Certify under penalty of law that this document and all attachments were prepared under TELEPHONE DATE <br /> my direction or supervision in accordance with a system designed to assure that qualified ?f <br />Brian A. W atterson, P.G. personnel propedy gather and evaluate the information submitted. Based on my inquiry of (( ?? 970 870 - 2750 <br />Geologist the person or persons who manage the system, or those persons directly responsible for SIGNATURE OF PRINCIPAL V 4QA <br /> gathering the information, the information submitted is, to the best of my knowledge and belief, OFFICER OR AUTHORIZED AGENT AREA CODE NUMBER YEAR MO DAY <br /> true, accurate, and complete. I am aware that there are significant penalties for submitting <br />TYPE OR PRINTED false information, including the possibility of fine and imprisonment for knowing violations. <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />Flow limit applies to combined flow from 003, 022, & 024. Oil & Grease grab sample analysis required if visible sheen is observed. Quarterly sampling instructions - I.C.12, PG. 9. <br />EPA Form 3320-1 (REV 3/99) Previous editions may be used THIS IS A 4-PART FORM PAGE 2 72