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PARAMETER <br />I certify under penalty of law that this document and all attachments were prepared under m direction or <br />superisioninacwrdance with a system dmignedto assure that qualifted personnel pro ly gather and <br />properly ga <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />FREQUENCY <br />ANALYSIS <br />SAM E <br />OF <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 />PERMIT <br />REQUIREMENT <br />fr` "• <br />Reeqq Mon. <br />INST MAX <br />Y =1;N =0 <br />.�� <br />••�• <br />*�� <br />Monthly <br />VISUAL <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICE <br />I certify under penalty of law that this document and all attachments were prepared under m direction or <br />superisioninacwrdance with a system dmignedto assure that qualifted personnel pro ly gather and <br />properly ga <br />>• .. - <br />TELEPHONE <br />DATE <br />SOMfS v- Ye10.•NC'CYs <br />I jr(5. c.. (4.tn. M r' <br />• t t N those i b the <br />persons m' Based oned le or inquiry attic person persons who manage a <br />system, or thou persons dve responsible for gathering the information, we a that t he re submitted si g n ed is, <br />to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant <br />penalties for submitting false infomation, including to possibility of fine and imprisonment for knowing <br />violations. <br />'� 4 1 <br />940 Q - <br />I'�V �/. ("' <br />/•t �1 <br />lJ �S O O �� <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code <br />NUMBER <br />MMIDDIYYYY <br />TYPED OR PRINTED <br />PERMITTEE NAME/ADDRESS (Include Facility Name /Location if Different) <br />NAME: Trapper Mining Inc <br />ADDRESS: PO Box 187 <br />Craig, CO 81626 -0187 <br />FACILITY: <br />LOCATION: <br />TRAPPER MINE <br />6.5 MI SW OT TOWN ON ST HWY 13 <br />CRAIG, CO 81625 <br />ATTN: Jim M. Mattern, Pres /GM <br />EPA Form 3320 -1 (Rev.01106) Previous editions may be used. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />FROM <br />C00032115 <br />PERMIT NUMBER <br />005 - A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />04/01/2011 <br />MM /DD/YYYY <br />06/30/2011 <br />TO <br />DMR Mailing ZIP CODE: 81626 - 0187 <br />MINOR <br />MOFAT <br />DISCHARGE TO COYOTE GULCH <br />Extemal Outfall <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />TSS & TOTAL IRON LIMITS WILL BE WAIVED, & SETTLEABLE SOLIDS LIMIT APPLIED FOR <= 10YR,24HR PRECIP EVENT -SEE BURDEN OF PROOF REQUIREMENTS UNDER I.A.2. TDS MONITORING - I.B.2. <br />Form Approved <br />OMB No. 2040-0004 <br />No Discharge <br />06/02/2011 Page 2 <br />BtA <br />