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PARAMETER <br />1 terrify under penalty to law that system m desig and all assure t h t qu a were personnel under my direction or <br />thatqualifiedp prepared 1properlygathe on <br />supmyun information submitted. ccordance withasystemdesignedto all attachments <br />valuate the i Baud on my inquiry of the person or persons who manage the <br />system, m those persons directly responsible for gathering the infomution, the information submitted is, <br />to the best of my knowledge and belief, true, accurate, and complete, l am aware that there are significant <br />penalties for submitting false information, including the possibility of fine and imprisonment for knowing <br />violations. <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 />Oil and grease visual <br />84066 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />TYPED OR PRINTED <br />PERMIT <br />REQUIREMENT <br />" <br />Reeqq Mon. <br />INST MAX <br />Y =1;N =0 <br />""" <br />""a' <br />.»a» <br />Month) y <br />VISUAL <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />1 terrify under penalty to law that system m desig and all assure t h t qu a were personnel under my direction or <br />thatqualifiedp prepared 1properlygathe on <br />supmyun information submitted. ccordance withasystemdesignedto all attachments <br />valuate the i Baud on my inquiry of the person or persons who manage the <br />system, m those persons directly responsible for gathering the infomution, the information submitted is, <br />to the best of my knowledge and belief, true, accurate, and complete, l am aware that there are significant <br />penalties for submitting false information, including the possibility of fine and imprisonment for knowing <br />violations. <br />/7//4 <br />TELEPHONE <br />DATE <br />T S <br />J Is/Mt� ///��� <br />I <br />fit .f1A _. t <br />/ a IfA <br />S - a^ c G � <br />i iq f <br />a� <br />a <br />a�j,.l 8 � y � pl <br />4 (C/ <br />/��.�( <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code <br />I NUMBER <br />MMIDDrmY <br />TYPED OR PRINTED <br />PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different) <br />NAME: Trapper Mining Inc <br />ADDRESS: PO Box 187 <br />Craig, CO 81626 -0187 <br />FACILITY: TRAPPER MINE <br />LOCATION: 6.5 MI SW OT TOWN ON ST HWY 13 <br />CRAIG, CO 81625 <br />ATTN: Jim M. Mattem, Pres /GM <br />EPA Form 3320.1 (Rev.01 /08) Previous editions may be used. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />FROM <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />000032115 <br />PERMIT NUMBER <br />)17 <br />018-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: 81626 - 0187 <br />MINOR <br />MOFAT <br />DISCHARGE TO HORSE GULCH <br />External Outfall <br />Form Approved <br />OMB No. 2040-0004 <br />TSS & TOTAL IRON LIMITS WILL BE WAIVED, & SETTLEABLE SOLIDS LIMIT APPLIED FOR <= 10YR,24HR PRECIP EVENT -SEE BURDEN OF PROOF REQUIREMENTS UNDER I.A.2. TDS MONITORING - I.B.2. <br />No Discharge <br />06/02/2011 Page 2 <br />