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PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different) <br />NAME: CAM Mining LLC <br />ADDRESS: PO Box 98 <br />Loma, CO 81524 <br />MUNGER CANYON MINE <br />3148 HWY 139 <br />LOMA, CO 81524 <br />FACILITY: <br />LOCATION: <br />ATTN: Richard Boone, Sr VP <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />FROM <br />COG850061 <br />PERMIT NUMBER <br />001 -A <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: 81524 <br />MINOR <br />Discharge to Munger Creek <br />External Outfall <br />Form Approved <br />OMB No. 2040-0004 <br />No Discharge <br />PARAMETER <br />pH <br />00400 1 0 <br />Effluent Gross <br />Solids, total suspended <br />00530 1 0 <br />Effluent Gross <br />Solids, settleable <br />00545 1 0 <br />Effluent Gross <br />Oil and grease <br />03582 1 0 <br />Effluent Gross <br />Flow, in conduit or thru treatment plant <br />50050 1 0 <br />Effluent Gross <br />Solids, total dissolved <br />70295 1 0 <br />Effluent Gross <br />Oil and grease visual <br />84066 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />QUANTITY OR LOADING <br />VALUE <br />VALUE <br />UNITS <br />QUALITY OR CONCENTRATION <br />VALUE <br />VALUE <br />VALUE <br />pup. <br />UNITS <br />NO. <br />EX <br />FREQUENCY <br />OF ANALYSIS <br />i3 <br />SAMPLE <br />TYPE <br />MEW <br />EPA Form 3320.1 (Rev.01 /06) Previous editions may be used. <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />Jim Stover, Agent <br />TYPED OR PRINTED <br />I certify under penal tyy of law that this document and all attachments were prepared under my direction or <br />supernston in accord0000 with a ryntem desipted to assure that qualified personnel properly gather and <br />evaluate theinfonnatioo submitted. Based on my inquiry of the person or persons who manage the <br />system, or those persons directly responsible for gathering the infomsation, the information submitted is, <br />to the best of my knowledge and belief, tree, accuote, and complete. lam aware that there are significant <br />penalties for submitting false information, including the possibility of fine kn <br />e and imprisonment for owing <br />au <br />S NATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT I <br />TELEPHONE <br />970 - 245 -4101 <br />AREACode NUMBER <br />DATE <br />10/04/2011 <br />MM/DD/YYYY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />Settleable solids limit waived for 10 -yr, 24 hr precip event subject to burden of proof requirements in Part 1.8.6. Any additional data shall be supplied to the division within 48 hours. <br />05/18/2011 Page 1 <br />