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PARAMETER ME /TITLEPRINCIPALEXECUTIVEOFFICER QUANTITY OR LOADING QUALITY OR CONCENTRATION E FREQUENCY OF ANALYSIS SAMPLE VALUE VALUE UNITS VALUE VALUE VALUE UNITS LC50 Statre 96Hr Acute Pimephales TAN6C 1 0 Effluent Gross SAMPLE MEASUREMENT AREA Cod. NUMBER MM/D /YYYY TYPED - OR PRINTED PERMIT REQUIREMENT — 100 MN VALUE % Quarterly GRAB PERMITTEE NAME /ADDRESS (Include Facility Name /Location if Different) NAME: Oxbow Mining LLC ADDRESS: PO Box 535 Somerset, CO 81434 -0535 FACILITY' SANBORN CRK & ELK CRK MINES LOCATION: 3737 HIGHWAY 133 SOMERSET, CO 81434 ATTN James T. Cooper, EVP EPA Form 3320 -1 (Rev.01 /06) Previous editions may be used. NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) DISCHARGE MONITORING REPORT (DMR) FROM 000000132 PERMIT NUMBER 015 -W DISCHARGE NUMBER MONITORING PERIOD MM /DD/YYYY 10/01/2011 MM /DD/YYYY 12/31/2011 TO Form Approved OMB No. 2040 -0004 DMR Mailing ZIP CODE: 81424 -0535 MINOR GUNIS ACUTE WET TESTING FOR 015A External Outfall No Discharge COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) SEE I A.4.A, PP 5-6 FOR DETAILS OFTEST PROCEDURE REPORT LC50 - STATISTICAL PINT WSTIMATE WHICH ISLETHAL TO 50% OF TEST ORGANISMS, AND ATTACH ACUTE TOXICITY TEST REPORT FORM TO DMR. 11/09/2011 Page 1 ME /TITLEPRINCIPALEXECUTIVEOFFICER I " mnunder pena lrcnt tau tb. n n� aebntentsmere preparwunder 0 t�r b�. aikventand .nm d1rnn0 r .upervmm� m accordance with a ,kste�n dewtbned to that yiuItred personnel properly and 1 f - T , ` w - TELEPHONE DATE Z C f - C 5/ f v '' v I I th f h tad H d v y ry f th pe p who g h• wyvem or tow pcnonw dneniv rewpuroible for gathenng the mformawn, the Information wubnurted n. to the bet of m. knowledge and belief true nc'umtc and wmpine I am aware that there are opal,. pn for submitting falke intormaoon mdumngthe poswibdn) of fine and impn..mmem or 4.,..T. � f -72q !! // S 6/ oY w1� IGNATURE OF PR CIPAL EXECUTIVE OFFICER OR ` AUTHORIZED AGENT AREA Cod. NUMBER MM/D /YYYY TYPED - OR PRINTED PERMITTEE NAME /ADDRESS (Include Facility Name /Location if Different) NAME: Oxbow Mining LLC ADDRESS: PO Box 535 Somerset, CO 81434 -0535 FACILITY' SANBORN CRK & ELK CRK MINES LOCATION: 3737 HIGHWAY 133 SOMERSET, CO 81434 ATTN James T. Cooper, EVP EPA Form 3320 -1 (Rev.01 /06) Previous editions may be used. NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) DISCHARGE MONITORING REPORT (DMR) FROM 000000132 PERMIT NUMBER 015 -W DISCHARGE NUMBER MONITORING PERIOD MM /DD/YYYY 10/01/2011 MM /DD/YYYY 12/31/2011 TO Form Approved OMB No. 2040 -0004 DMR Mailing ZIP CODE: 81424 -0535 MINOR GUNIS ACUTE WET TESTING FOR 015A External Outfall No Discharge COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) SEE I A.4.A, PP 5-6 FOR DETAILS OFTEST PROCEDURE REPORT LC50 - STATISTICAL PINT WSTIMATE WHICH ISLETHAL TO 50% OF TEST ORGANISMS, AND ATTACH ACUTE TOXICITY TEST REPORT FORM TO DMR. 11/09/2011 Page 1