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PARAMETER <br />1 certify under penalty of law that this document and all attachments were prepared under my direction or <br />m as <br />supervision in accordance with a system designed sure that qualified personnel properly gather and <br />i Based inquiry <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 />,,,,..e <br />•••••• <br />•••••• <br />•••••• <br />PERMIT <br />REQUIREMENT <br />•••`•• <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />•'•`•• <br />••• "•• <br />Weekly <br />VISUAL <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICE <br />1 certify under penalty of law that this document and all attachments were prepared under my direction or <br />m as <br />supervision in accordance with a system designed sure that qualified personnel properly gather and <br />i Based inquiry <br />� 1/ <br />n 7-et),/ <br />y� ,/ ( 7�, �/ <br />1 /,// <br />TELEPHONE <br />DATE <br />ed T y y p �/ <br />yt the s ion submitted. of person or who manage the <br />system, or those se persons directly responsible for or gathering the information, a, e a re thmutirgned o <br />t <br />to the best of my knowledge an tiva edge and belief, accurate, nm, and compleette. e. I am aware that the are re significant <br />to t <br />penalties for submitting false information, including the possibility of fine and imprisonment for knowing <br />violations <br />.97.0-901-- 5 a <br />W / / ` // / y� i <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code NUMBER <br />MMIDO/YYYY <br />TYPED OR PRINTED <br />PERMITTEE NAME/ADDRESS (Include Faciiity Name/Location ifDifferent) <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.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 />003A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />09/01/20130 <br />1 <br />MM /DD/YYYY <br />09/30/2083 <br />TO <br />f t <br />o <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR WI) DELTA <br />SR;DEER TRL DTC OR UNMD TRIB <br />External Outfall <br />Form Approved <br />OMB No. 2040 -0004 <br />No Discharge <br />Page 2 <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, 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 />