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PARAMETER <br />Icem of fyunderpenaltyoawthatthis documentandall attachment swere preparedundermydirectionor <br />ion in accordance with a system designed to assure that qualified personnel properly gather and <br />evaluate the information submitted. Based on my inquiry of the person or persons who manage the <br />system, or those persons directly responsible for gathering the information. the information submitted is, <br />to the best of my knowledge and belie( true, accurate. and complete. l am aware that there are significant <br />pe'aWesfor submitting false inr anon, including the possibility of tine and imprisonment for owing <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />EX <br />FREQUENCY <br />OF ANALYSIS <br />SAMPLE <br />TYPE <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 />...... <br />e <br />» .... <br />A <br />er <br />VISUAL <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />"* "* <br />Weekly <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICE <br />Icem of fyunderpenaltyoawthatthis documentandall attachment swere preparedundermydirectionor <br />ion in accordance with a system designed to assure that qualified personnel properly gather and <br />evaluate the information submitted. Based on my inquiry of the person or persons who manage the <br />system, or those persons directly responsible for gathering the information. the information submitted is, <br />to the best of my knowledge and belie( true, accurate. and complete. l am aware that there are significant <br />pe'aWesfor submitting false inr anon, including the possibility of tine and imprisonment for owing <br />/ c <br />TELEPHONE <br />DATE <br />l <br />9� ' Q4 5. � <br />O (� — . 9 • � <br />Dew W l CS ey r annev <br />G <br />SIGNA OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code I NUMBER <br />MMIDDIYYYY <br />� YPED OR PRINTED <br />PERMITTEE NAME/ADDRESS ( /nc/ude Faci/it)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 />Ua <br />MM /DD/YYYY <br />09/3n/2n09 <br />07- of - i t <br />001 A <br />DISCHARGE NUMBER <br />TO <br />07 -3 - /1 <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 Discharger <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.8.1,3, PG 9. QRTRLY SAMPLING INSTRUCTIONS- 1.C.10, PG. 10. <br />Page 2 <br />