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PARAMETER <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />FREQUENCY <br />OF ANALYSIS <br />SA PE E <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 />...a.. <br />.....• <br />PERMIT <br />REQUIREMENT <br />R. Mon. <br />d NST eqq M AX <br />Y =1;N =0 <br />` <br />'. <br />' .... <br />Twice Per : <br />; : Month' • <br />' VISUAL <br />PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different) <br />NAME: Blue Mountain Energy Inc <br />ADDRESS: 3607 CR 65 <br />Rangely, CO 81648 <br />DESERADO MINE <br />3607 CR 65 <br />RANGELY, CO 81648 <br />FACILITY: <br />LOCATION: <br />ATTN: ALAN HILLARD, MINE MGR <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 />C00038024 <br />PERMIT NUMBER <br />005 -A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />7/1/2011 <br />MM /DD/YYYY <br />9/30/2011 <br />TO <br />DMR Mailing ZIP CODE: 81648 <br />MINOR <br />(SUBR DW) RBLAN <br />RR -1 LOADOUT TO RED WASH <br />Extemal Outfall <br />Form Approved <br />OMB No. 2040-0004 <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />Scott Wanstedt, Environmental Engineer <br />TYPED OR PRINTED <br />I certify under penalty or law that this document and all alWmenb <br />Ch wen prepeml under my dlmginn ALA. <br />supervision in accordance with a system designed to assure that qualified personnel properly gather and <br />evaluate the in! ninon submitted. limed on my inquiry of the person or persons who manage the <br />system. or those persons directly rrspo Bible forgathering the information. the infonmiion submitted is. <br />to the lust of my knowledge and belief. true,:4crnatc. and complete. I am aware that there are significant <br />penalties tar submitting false ,nr neutron. including the possibility of tine and imprisonment for knowing <br />iolai on <br />TELEPHONE <br />SIGNATU - E OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />(970) 675-4322 <br />AREA Code NUMBER <br />DATE <br />10/25/2011 <br />MM /DD/YYYY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />TSS & TOTAL IRON LIMITS WILL BE WAIVED FOR 10YR,24HR PRECIP EVENT - SEE I.A.1, PG. 3. FOR REQUIREMENTS.OIL & GREASE REPORTING - I.B.1.., PG. 13. QRTRLY SAMPLING INSTRUCTIONS - I.C.7., PG. 14. <br />No Discharge <br />05/11/2011 Page 2 <br />0 <br />