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PARAMETER <br />Ie ettify m m, <br />derpe nalty oflawthatthisdocumen tandallattachment suereprepar,dmxmydirecionor <br />supervision in accordssee with a system designed m assure that qualified personnel property gather and <br />evaluate me information mbmined. Based on my inquiry of the person or persons who manage the <br />system. or o f m p dttan responsible for gathamg the information, the information submitted u. <br />m me best army knowledge and d belief. true. accurate, and complete. l am m aware that t hem are e si aignir,�m <br />penalties for submitting false infurmuion, including the possibility of f and imprisonment for knowin <br />violations <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />O6 <br />Z <br />FREQUENCY <br />OF ANALYSIS <br />SAMPLE <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 />TYPED OR PRINTED <br />.. ».. <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />INST MAX <br />Y =1:N =0 <br />a "'aa <br />•.`.'• <br />Monthly <br />VISUAL <br />NAMElTITLEPRINCIPALEXECUTIVEOFFICER <br />Ie ettify m m, <br />derpe nalty oflawthatthisdocumen tandallattachment suereprepar,dmxmydirecionor <br />supervision in accordssee with a system designed m assure that qualified personnel property gather and <br />evaluate me information mbmined. Based on my inquiry of the person or persons who manage the <br />system. or o f m p dttan responsible for gathamg the information, the information submitted u. <br />m me best army knowledge and d belief. true. accurate, and complete. l am m aware that t hem are e si aignir,�m <br />penalties for submitting false infurmuion, including the possibility of f and imprisonment for knowin <br />violations <br />1 r► <br />I ui� t a <br />V •• C <br />TELEPHONE <br />DATE <br />CXC' <br />/r <br />�r P Si �e <br />/f�A C2 �_ �d/I / <br />7 {/ / p o6 <br />/ <br />/ <br />/0 0 <br />2.0 it <br />D/YYYY <br />I <br />IGNATURE OF P CIPAL EXECUTIVE OFFICER OR <br />R[ � <br />AUTHORIZED AGENT <br />1 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 />FACILITY: <br />LOCATION: <br />SANBORN CRK & ELK CRK MINES <br />3737 HIGHWAY 133 <br />SOMERSET, CO 81434 <br />ATTN: James T. Cooper, EVP <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 />C00000132 <br />PERMIT NUMBER <br />016 - A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />09/01/2011 <br />MM /DD/YYYY <br />09/30/2011 <br />TO <br />DMR Mailing ZIP CODE: 81424-0535 <br />MINOR <br />GUNIS <br />SURFACE RUNOFF TO ELK CREEK <br />External Outfall <br />Form Approved <br />OMB No. 2040-0004 <br />No Discharge <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />TSS & TOTAL IRON LIMITS WILL BE WAIVED, AND SETTLEABLE SOLIDS LMT APPLIED FOR < =10YR,24 HR PRECIP EVENT :SETTLEABLE SOLIDS LIMITS MAY BE WAIVED FOR >10YR,24HR EVENT-SEE I.A.1, PP 4-5, AND LA.2., P. 5 <br />FOR RQMNTS. TDS MONITORING -SEE PART VI.A.2.G OF RATIONALE. 30 DAY AVG IS HIGHEST MONTHLY AVG DURING PERIOD RPTD. <br />Page 2 <br />