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PARAMETER <br />1 certify under penalty of law that this document and all anachments were prepared under my direction or <br />mp lo ot o accordance in nnotio haayste designed mquir y that qualified personnel properly mamg ether end <br />v lust "n submitted. rims on Based my inquiry as o o f the person or or persons s who menage the <br />system, or those persons directly responsible for gathering the information, the information submitted is. <br />to the best of my knowledge and belief, hue, accurate. and complete. l am aware that there are significant <br />penalties for submitting false information, includi the possibility of fine and imprisonment for knowing <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />O. <br />EX <br />FREQUENCY <br />OF ANALYSIS <br />SAMPLE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNITS <br />Oil and grease visual <br />84066 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />Pb <br />,,,,,, <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />INST MAX <br />Y =1; =0 <br />..a * *f <br />* *R *e1 <br />.... #f <br />Weekly <br />VISUAL <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />1 certify under penalty of law that this document and all anachments were prepared under my direction or <br />mp lo ot o accordance in nnotio haayste designed mquir y that qualified personnel properly mamg ether end <br />v lust "n submitted. rims on Based my inquiry as o o f the person or or persons s who menage the <br />system, or those persons directly responsible for gathering the information, the information submitted is. <br />to the best of my knowledge and belief, hue, accurate. and complete. l am aware that there are significant <br />penalties for submitting false information, includi the possibility of fine and imprisonment for knowing <br />� � l SV"C/ r <br />TELEPHONE <br />DATE <br />� / <br />^ � - c. <br />( , <br />/ /& <br />C p / / {� // <br />��� �� �� <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Coda NUMBER <br />I <br />MMIDDM'YY <br />TYPED OR PRINTED <br />PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different) <br />NAME: Bowie Resources LLC <br />ADDRESS: PO Box 483 <br />Paonia, CO 81428 <br />FACILITY: BOWIE NO. 2 MINE <br />LOCATION: 5 MI NE OF TOWN ON CO HWY 133 <br />PAONIA, CO 81428 <br />ATTN: BRADLEY E. HANSON, VICE PRES. <br />EPA Form 3320 - 1 (Rev.01 /06) Previous editions may be used. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />FROM <br />C00044776 <br />PERMIT NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />09989.1 <br />MM /DD/YYYY <br />5' J' oZtj/ I <br />001A <br />DISCHARGE NUMBER <br />TO <br />S- 3/ - <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />SR/MINE WTR TO DEER TRAIL DTCH <br />External Outfall <br />Form Approved <br />OMB No. 2040-0004 <br />No Discharge <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SETTLEABLE SOLIDS LIMIT APPLIES ONLY IF <10YR,24HR PRECIP EVENT IS CLAIMED. IF CLAIM APPROVED BY WQCD,TSS & IRON LIMITS WILL NOT BE APPLIED TO REPORTED MEASUREMENTS -SEE I.A.3, PG 4 -5 FOR <br />BURDEN OF PROOFREQUIREMENTS. OIL & GREASE I.B.1,3, PG 9. QRTRLY SAMPLING INSTRUCTIONS- I.C.10, PG. 10. <br />Page 2 <br />