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PARAMETER <br />1 mrify under penalty of law that this document and all attachments were prepared under my direction or <br />in <br />sup tsion r <br />lt d n m yi iopnperson properly <br />I i f Based <br />Bas eas <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 />84066 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />,,..,, <br />MM/DD/YYYY <br />...* <br />"���` <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />Weekly <br />VISUAL <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICE <br />1 mrify under penalty of law that this document and all attachments were prepared under my direction or <br />in <br />sup tsion r <br />lt d n m yi iopnperson properly <br />I i f Based <br />Bas eas <br />\/ `' <br />TELEPHONE <br />DATE <br />/ J� � <br />r / (�.{ <br />� ecl �h h e v' <br />sub <br />to mut sub o inquiry th the perersoo o <br />n persons manage the <br />system, or r those persons directly ly responsible <br />sponsible le my i for gathering the e information, n, t information utioo submitted is, <br />m the <br />he es[ o my knowledge knowledge and i true, accurate, and complete. I aware that these are significant <br />to t i submitting es for false information, including the passibility of fine ne and imprisonment for knowing <br />violations. <br />42!) _9 G 7 ') 1 � � r] C" 1 <br />/ <br />/ (� /I <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />l J TYPED OR PRINTED <br />/) <br />AREA Code NUMBER <br />MM/DD/YYYY <br />PERMITTEE NAME/ADDRESS (Include FaciOlyName/Locat ' on if Different) <br />NAME: <br />ADDRESS: <br />FACILITY: <br />LOCATION: <br />Bowie Resources LLC <br />PO Box 483 <br />Paonia, CO 81428 <br />BOWIE NO. 2 MINE <br />5 MI NE OF TOWN ON CO HWY 133 <br />PAONIA, CO 81428 <br />ATTN: BRADLEY E. HANSON, VICE PRES. <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <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 />C00044776 <br />PERMIT NUMBER <br />005A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />09/01/2089• <br />MM /DD/YYYY <br />09/30/2099 <br />tl <br />TO <br />t1 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />SR;DEER TRL DTC OR UNMD TRIG <br />Extemal Outfall <br />Form Approved <br />OMB No. 2040 -0004 <br />No Discharge <br />SETTLEABLE SOLIDS LIMIT APPLIES ONLY IF <10YR,24HR PRECIP EVENT IS CLAIMED. IF CLAIM APPROVED BY WQCD,TSS & IRON LIMITS WILL NOT BE APPLIED TO REPORTED MEASUREMENTS -SEE I.A.3, PP 4-5 FOR <br />BURDEN OF PROOFREQUIREMENTS. OIL & GREASE- I.B.1.E, PG 9. QRTRLY SAMPLING INSTRUCTIONS - I.C.10, PG. 10. <br />Page 2 <br />