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PERMITTEE NAME /ADDRESS (Include Facility Name/Location "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 />84066 1 0 <br />Effluent Gross <br />PARAMETER <br />Oil and grease visual <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />TYPED OR PRINTED <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />EPA Form 3320_1 (Rev.01 /06) Previous editions may be used. <br />VALUE <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />FROM <br />C00044776 <br />PERMIT NUMBER <br />MONITORING PERIOD <br />MMIDDIYYYY <br />.99/A4f eeg — <br />MM /DD/YYYY <br />40O#38/2889--- <br />-� / - /(I <br />QUANTITY OR LOADING <br />VALUE <br />/1/d <br />Req. Mon. <br />INST MAX <br />UNITS <br />Y =1;Nm0 <br />TO <br />I certify ender penalty of taw that this document and all attachment were prepared older my direction or <br />supenisioo in accordance with a system designed to assure that qualified personnel properly gather and <br />evaluate the iofommtion submitted Rased on my inquiry of the person or penoos who menage the <br />system, or those persona directly responsible for gathering the information. Me information submitted is. <br />to the best of my knowlefte and belief, nue. aecunte. and complete. I am aware that there are sigoifsmu <br />penalties for submitting fake information. including the possibility of fine and imprisonment for knowing <br />violations. <br />002A <br />DISCHARGE NUMBER <br />G - 36 -/ <br />VALUE <br />QUALITY OR CONCENTRATION <br />VALUE <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />SR ;DEER TRL DIG OR UNMD TRIB <br />External Outfall <br />VALUE UNITS <br />0*tn <br />NO. <br />EX <br />FREQUENCY <br />OF ANALYSIS <br />TELEPHONE DATE <br />Form Approved <br />OMB No. 2040-0004 <br />No Discharge,® <br />AREA Code NUMBER MMIDDFYYYY <br />SAMPLE <br />TYPE <br />VISUAL <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, PP 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 />