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PARAMETER <br />1 certify under penalty of lac that this document and all attachments were prepated under my direction or <br />isioninaccordancewith as y, temdesignedto assuret hatqualifiedper sonnelproperlygatherand <br />evaluate the information submiued. Based on my um try of the person or persons who manage the <br />system. or those person directly moons Mk f gad:ring the infommtion the inf ti submitted u, <br />to the bet of my knowledge and belief true, auuute, and complete. t am aware that these are significant <br />penalties for submitting false information, including the possibility ors and imprisonment for knowing <br />violations. <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />O6 <br />z <br />OF AN FAN AL L YS <br />YSI S <br />ST <br />YPPEE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNITS <br />LC50 Statre 96Hr Acute Pimephales <br />TAN6C 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />...a.. <br />....., <br />...... <br />...... <br />PERMIT <br />REQUIREMENT <br />"a'a' <br />"`a" <br />100 <br />MN VALUE <br />w""• <br />....., <br />% <br />Quarterly <br />GRAB <br />AMERITLE PRINCIPAL EXECUTIVE OFFICE super, <br />1 certify under penalty of lac that this document and all attachments were prepated under my direction or <br />isioninaccordancewith as y, temdesignedto assuret hatqualifiedper sonnelproperlygatherand <br />evaluate the information submiued. Based on my um try of the person or persons who manage the <br />system. or those person directly moons Mk f gad:ring the infommtion the inf ti submitted u, <br />to the bet of my knowledge and belief true, auuute, and complete. t am aware that these are significant <br />penalties for submitting false information, including the possibility ors and imprisonment for knowing <br />violations. <br />t� f fa y�• <br />, J I �� T <br />TELEPHONE <br />DATE <br />� a � T Co0 <br />1 I / <br />��� a /' ?re <br />^ 0Q 4 <br />�6/03/45 7,. If <br />MIA/ YYY <br />NATURE OF PFUI EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Cod. NUMBER <br />TYPED OR PRINTED <br />PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different) <br />NAME: Oxbow Mining LLC <br />ADDRESS: PO Box 535 <br />Somerset, CO 81434 -0535 <br />SANBORN CRK & ELK CRK MINES <br />3737 HIGHWAY 133 <br />SOMERSET, CO 81434 <br />FACILITY: <br />LOCATION: <br />ATTN: James T. Cooper, EVP <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 />C00000132 <br />PERMIT NUMBER <br />015-W <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />07/01/2011 <br />MM /DD/YYYY <br />09/30/2011 <br />TO <br />DMR Mailing ZIP CODE: 81424 -0535 <br />MINOR <br />GUNIS <br />ACUTE WET TESTING FOR 015A <br />Extemal Outfall <br />Form Approvoa <br />OMB No. 2040-0004 <br />No Discharg <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SEE I.A.4.A, PP 5-6 FOR DETAILS OFTEST PROCEDURE, REPORT LC50 - STATISTICAL PINT WSTIMATE WHICH ISLETHAL TO 50% OF TEST ORGANISMS, AND ATTACH ACUTE TOXICITY TEST REPORT FORM TO DMR. <br />Page 1 <br />