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PARAMETER <br />I certify under penalty of law that this document and all attachments were prepared under my direction or <br />snpersi t in accordance with e sy designed to assure that qualified personnel properly gather and <br />evaluate c t h e information submitted stem Based on my inquiry of the person or persons w manage the <br />system, or those persons directly responsible fm gathering the information, the information submitted is, <br />to the but of knowledge and belief, true, l n and complete. y o I aware that there are significant <br />penalties sub ubminngfalse information, indudiding t bepoasbilirytfiate neand hnpsonmrn <br />imprisonment <br />violations. m�a. <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />EX <br />FREQUENCY <br />OF ANALYSIS <br />SAMPLE <br />TYPE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNITS <br />Oil and grease visual <br />8406610 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />/J) <br />C/ <br />- <br />O <br />11 <br />V <br />PERMIT <br />REQUIREMENT <br />Req Mon. <br />INST M AX <br />Y =1;N =0 <br />... <br />. <br />.«.a <br />Monthly <br />VISUAL <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />I certify under penalty of law that this document and all attachments were prepared under my direction or <br />snpersi t in accordance with e sy designed to assure that qualified personnel properly gather and <br />evaluate c t h e information submitted stem Based on my inquiry of the person or persons w manage the <br />system, or those persons directly responsible fm gathering the information, the information submitted is, <br />to the but of knowledge and belief, true, l n and complete. y o I aware that there are significant <br />penalties sub ubminngfalse information, indudiding t bepoasbilirytfiate neand hnpsonmrn <br />imprisonment <br />violations. m�a. <br />I <br />�Z 7 <br />TELEPHONE <br />DATE <br />11 /,1, <br />°(4Vt6gs I /t t a T7 et � t <br />�� !! <br />w •r'R Gc�► <br />P� 5 _ a r <br />I - W <br />/ 'C' �� 7 i 0/ <br />7 � <br />at�f/ // <br />/0 5 <br />S IGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />TYPED OR PRINTED <br />AREA Code <br />I NUMBER <br />MMIDD/YYYY <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 /06) 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 />024-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 WEST HORSE GULCH <br />External Outfall <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 />Form Approved <br />OMB No. 2040-0004 <br />No Discharge <br />06/02/2011 Page 2 <br />