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NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />le rnir nu ;.an<nmemm,anum M Wwdermyaincfim,or <br />sap s ,m ;naemm n« w; dtas „ aprw,nipmperty <br />mimic the information submitted. Based on my inquiry of the person or persons who manage the <br />system, orfhmeprnnns directly rcx�, onsiblefor gnthenngthe infmwlmn .the in(nmwlinnsubmitted is. <br />edge and belief, Inn, accurate. and complete. l am aware that Mere am significant <br />.111e hestnfany knowledge w <br />pmuhiextor suhmirong false information, including the po.iWility of fine and imprisonment lift knowing <br />� <br />-� <br />� �r � <br />r TELEPHONE <br />DATE <br />Wanstedt, Environmental Engineer <br />< <br />,",�— � _ � , i ! ” -- . <br />• Scott <br />(970) 675 -4322 <br />10/25/2011 <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code I NUMBER <br />MM/DD/YYYY <br />TYPED OR PRINTED <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.01 /06) 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 />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />OIL & GREASE REPORTING -SEE 1.8.1.A, PG 13. QRTRLY SAMPLING INSTRUCTIONS - I.C.7, PG. 14. <br />004 -A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM/DD/YYYY <br />7/1/2011 <br />MM /DDIYYYY <br />9/30/2011 <br />TO <br />DMR Mailing ZIP CODE: 81648 <br />MINOR <br />(SUBR DW) RBLAN <br />PP2 TO SCULLION GULCH <br />Extemal Outfall <br />Form Approved <br />OMB No. 2040-0004 <br />No Discharge <br />PARAMETER <br />BOD, 5 -day, 20 deg. C <br />00310 1 0 <br />Effluent Gross <br />pH <br />004001 0 <br />Effluent Gross <br />Solids, total suspended <br />00530 1 0 <br />Effluent Gross <br />Solids, settleable <br />005451 0 <br />Effluent Gross <br />Iron, total (as Fe) <br />01045 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 />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 />7, <br />30D A AVG <br />Req. Mon. <br />30DA AVG <br />VALUE <br />.042 <br />DAILY MX <br />UNITS <br />Ib /d <br />MgaId <br />QUALITY OR CONCENTRATION <br />VALUE <br />6.5 <br />MINIMUM <br />VALUE <br />300A AVG <br />32.5..: <br />30DA AVG <br />3.5 :. <br />30DA'AVG <br />VALUE <br />4 <br />MX 0 AV <br />9 <br />MAXIMUM <br />70 <br />MX 70 AV <br />.5 <br />DAILY MX :( <br />7 <br />DAILY MX`' <br />10.._ <br />INST MAX <br />UNITS <br />mg t.... <br />S <br />mL/L <br />mg/L <br />mg /L <br />NO. <br />EX <br />FREQUENCY <br />OF ANALYSIS <br />Twice Per <br />Month <br />Twice Per <br />Month .. <br />Twice Per <br />Month <br />Twice Per <br />Month <br />Twice Per 1: <br />Month <br />Contingent <br />Monthly <br />SAMPLE <br />TYPE <br />GRAB >' <br />INSITU <br />GRAB <br />GRAB <br />GRAB <br />GRAB <br />INSTAN <br />05/11/2011 Page 1 <br />