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PARAMETER <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />O. <br />EX <br />FREQUENCY <br />OF ANALYSIS <br />SAMPLE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNITS <br />Chlorine, total residual <br />50060 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />.5 <br />DAILY MX <br />mg /L <br />Twice Per <br />Month <br />GRAB .; <br />Solids, total dissolved <br />702951 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />QRTR AVG <br />Req. Mon : <br />DAILY MX <br />mg /L <br />Quarterly <br />GRAB <br />Coliform, fecal general <br />74055 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />,..... <br />PERMIT <br />REQUIREMENT <br />2000 <br />30DAVGEO <br />4000 <br />MX7DGEOA <br /># /100mL <br />Twice Per <br />Month <br />GRAB <br />Oil and grease visual <br />84066 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />. »... <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />INST MAX : <br />Y =1;N =0 <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 />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />Scott Wanstedt, Environmental Engineer <br />TYPED OR PRINTED <br />EPA Form 3320.1 (Rov.01 /06) Previous editions may be used. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (OMR) <br />FROM <br />C00038024 <br />PERMIT NUMBER <br />1 eenify under penally of law that this document and all atmehmentv were prepared under my diroclion or <br />for <br />ev the submit) rl Based on any d assure or qualified or personnel wproperly <br />ro m r no b diner and <br />lhan nc�i <br />inquiry u I 1 <br />t the or of my persons directly be <br />mid responsible for Inn, rate. and complete. t lam aware e th ro si <br />ps is, <br />petheIwsrofmykuuwl knowledge o, in c accurate. t he possibility line ne and imprisonment fmesignnwmg <br />mltie.. suhmining raise infnm,alin, including one nd iprionmem tnmeing <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />OIL & GREASE REPORTING -SEE I.B.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 /DD/YYYY <br />9/30/2011 <br />TO <br />DMR Mailing ZIP CODE: 81648 <br />MINOR <br />(SUBR DW) RBLAN <br />PP2 TO SCULLION GULCH <br />External Outfall <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />TELEPHONE <br />(970) 675 -4322 <br />AREA Code ( NUMBER <br />Form Approved <br />OMB No. 2040-0004 <br />No Discharge <br />DATE <br />10/25/2011 <br />MM/DD/YYYY <br />05/11/2011 Page 2 <br />0 <br />