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PARAMETER <br />1 certiry under penalty of law that this document and all attachments were prepared under my direction or <br />sttpervtsion in accordance with a system designed to assure that qualified personnel properly gather and <br />evaluate the information submitted. Baud on my inquiry ofthe person or persons who manage the <br />system, or thou persons directly g and responsible for gathering the information, the information hat thre submitted is, <br />to the best se knowledge and belie[ we, accurate, and complete. l a ,were that there evil t <br />„o nsorsnbminingfaluinr information, <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <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 />...... <br />,�,� <br />`G <br />,...a. <br />...,.. <br />.,e.,, <br />L <br />1" J <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />INST MAX <br />Y=1 ;N=0 <br />Weekly <br />VISUAL <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFIC <br />1 certiry under penalty of law that this document and all attachments were prepared under my direction or <br />sttpervtsion in accordance with a system designed to assure that qualified personnel properly gather and <br />evaluate the information submitted. Baud on my inquiry ofthe person or persons who manage the <br />system, or thou persons directly g and responsible for gathering the information, the information hat thre submitted is, <br />to the best se knowledge and belie[ we, accurate, and complete. l a ,were that there evil t <br />„o nsorsnbminingfaluinr information, <br />/, V <br />' / .. ` /� <br />TELEPHONE <br />DATE <br />('� <br />{ &.Q ec, i a� In / <br />Imo! W ID lR <br />Q �jy� �j .''] �°� <br />7D / 5:2 ! <br />/) � 1 I i <br />{ / I / <br />'��`�"'-'-+r1/ <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code <br />NUMBER <br />MM/DDIYYYY <br />O TYPE P <br />PERMITTEE NAME/ADDRESS (Include Faci/ /tyName✓Location if Different) <br />NAME: Bowie Resources LLC <br />ADDRESS: PO Box 483 <br />Paonia, CO 81428 <br />FACILITY: BOWIE NO. 2 MINE <br />LOCATION: 5 MI NE OF TOWN ON CO HWY 133 <br />PAONIA, CO 81428 <br />ATTN: BRADLEY E. HANSON, VICE PRES. <br />EPA Form 3320 - 1 (Rev.01106) 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 />MONITORING PERIOD <br />MM /DD/YYYY <br />09/01/20Q9 <br />MM /DD/YYYY <br />09/30/2048 <br />( <br />001A <br />DISCHARGE NUMBER <br />TO <br />1 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />SR/MINE WTR TO DEER TRAIL DTCH <br />Extemal Outfall <br />Form Approved <br />OMB No. 2040-0004 <br />No Discharge <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <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, PG 4-5 FOR <br />BURDEN OF PROOFREQUIREMENTS. OIL & GREASE - 1.8.1,3, PG 9. QRTRLY SAMPLING INSTRUCTIONS-1.C.10, PG. 10. <br />Page 2 <br />