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NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />I emify undo penalty of law that this document and all attachmentswerc prepared under my domino or <br />supemsiou is once whn n system daigaed in assurc that quotdlcd persomel property gather aad <br />evaluate the infomutioo submitted. Based m d my mquity of the poison or persotu who manage the <br />system, or those peron=directly responsible for gamenag the information, the information submitted is. <br />farg �m <br />pmca�ileiafmmbmiviag aadbelteGu clu arate,a p bit i'ete'm cnndim hitthe<eercai ci <br />violations. f alsciofonmtiog ineludiagtheposs ibiiiryoffuuaadim priwmocm <br />! TELEPHONE <br />DATE <br />(970) 675 -4322 <br />07/25/2011 <br />Scott Wanstedt, Environmental Engineer <br />9 <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code <br />I NUMBER <br />MMfDDIYYYY <br />TYPED OR PRINTED <br />PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different) <br />NAME: <br />ADDRESS: <br />FACILITY: <br />LOCATION: <br />Blue Mountain Energy Inc <br />3607 CR 65 <br />Rangely, CO 81648 <br />DESERADO MINE <br />3607 CR 65 <br />RANGELY, CO 81648 <br />ATTN: ALAN HILLARD, MINE MGR <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />FROM <br />C00038024 <br />PERMIT NUMBER <br />005 -A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM/DD/YYYY <br />4/1/2011 <br />MM/DD/YYYY <br />6/30/2011 <br />TO <br />DMR Mailing ZIP CODE: 81648 <br />MINOR <br />(SUBR DW) RBLAN <br />RR -1 LOADOUT TO RED WASH <br />External Outfall <br />Form Approved <br />OMB No. 2040 -0004 <br />No Discharge <br />PARAMETER <br />Oil and grease visual <br />84066 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />QUANTITY OR LOADING <br />VALUE <br />VALUE <br />Reqq. Mon. <br />INST: MAX: <br />UNITS <br />QUALITY OR CONCENTRATION <br />VALUE <br />VALUE <br />VALUE <br />UNITS <br />NO. <br />EX <br />FREQUENCY <br />OF ANALYSIS <br />Twice Per <br />Month :.. <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />TSS & TOTAL IRON LIMITS WILL BE WAIVED FOR 10YR,24HR PRECIP EVENT - SEE I.A.1, PG. 3. FOR REQUIREMENTS.OIL & GREASE REPORTING - I.B.1.., PG. 13. QRTRLY SAMPLING INSTRUCTIONS - I.C.7., PG. 14. <br />EPA Form 3320 -1 (Rev.01 /06) Previous editions may be used. <br />05/11/2011 <br />SAMPLE <br />TYPE <br />VISUAL <br />Page 2 <br />