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PARAMETER <br />1 certify oodrr perch of law thm this docomrot and all ""h"'''' were P'''''''d w *r my d,nxrioo <br />■ NAME <br />supe in foatod o wrier md*rrgnrd to avwethat goohfudpesomrel C PI"" ::: evaloue the info roo wbmiucd. B000d on my im airy of thr: person m persons rr o mango the <br />10 irrb rro nada*ly iwef°` " "gth<infnmatron theiofnmwtwnaahminedu. <br />mthnbnn ofm d urd re ponrib e.uoomqug kr".lo awaredutdrerea fo r d <br />r�wu m� ea"b"""n¢ue"dmmWm rodudmgdapo"� yoffo<am mpneonmem� �Owme <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 />Chlorine, total residual <br />50060 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />». ». <br />... ». <br />.,. ». <br />»...• <br />» ».. <br />PERMIT <br />REQUIREMENT <br />'�.»• <br />«.«. <br />«` «+ <br />««.. <br />.5 <br />DAILY MX <br />mg/L <br />Twice Per <br />Month <br />GRAB <br />Solids, total dissolved <br />70295 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />. » ». <br />... ». <br />»».• <br />...... <br />PERMIT <br />REQUIREMENT <br />"' « . <br />.. ... <br />....» <br />»... <br />Req. Mon. <br />QRTR AVG <br />Req. Mon. <br />DAILY MX <br />mg/L <br />Quarterly <br />GRAB <br />Coliform, fecal general <br />74055 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />. » »• <br />.•.... <br />».»■ <br />PERMIT <br />REQUIREMENT <br />...... <br />««" <br />«.'"■ <br />2000 <br />3OD <br />4000 <br />MX7DGEOA <br />#ll00ml <br />Twice Per <br />Month <br />GRAB <br />Oil and grease visual <br />84066 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />. »... <br />»...• <br />» ».. <br />. ».» <br />...». <br />PERMIT <br />REQUIREMENT <br />" "" <br />Req. Mon. <br />INST MAX <br />Y =1:N =0 <br />"'"` <br />""" <br />""" <br />mi.,. <br />Twice Per <br />Month <br />VISUAL <br />/TITLE PRINCIPAL EXECUTIVE OFFICER <br />1 certify oodrr perch of law thm this docomrot and all ""h"'''' were P'''''''d w *r my d,nxrioo <br />■ NAME <br />supe in foatod o wrier md*rrgnrd to avwethat goohfudpesomrel C PI"" ::: evaloue the info roo wbmiucd. B000d on my im airy of thr: person m persons rr o mango the <br />10 irrb rro nada*ly iwef°` " "gth<infnmatron theiofnmwtwnaahminedu. <br />mthnbnn ofm d urd re ponrib e.uoomqug kr".lo awaredutdrerea fo r d <br />r�wu m� ea"b"""n¢ue"dmmWm rodudmgdapo"� yoffo<am mpneonmem� �Owme <br />TELEPHONE <br />DATE <br />+-- <br />(970) 675 -4322 <br />01/09/2012 <br />Scott Wanstedt, Environmental Engineer <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Cod" I NUMBER <br />MM/DD/YYYY <br />TYPED OR PRINTED <br />PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different) <br />NAME: <br />ADDRESS: <br />FACILITY: <br />LOCATION: <br />Blue Mountain Energy Inc <br />3607 CR 65 <br />Rangeiy, CO 81648 <br />DESERADO MINE <br />3607 CR 65 <br />RANGELY, CO 81648 <br />ATTN: ALAN HILLARD, MINE MGR <br />FROM <br />C00038024 <br />PERMIT NUMBER <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />OIL & GREASE REPORTING -SEE I.B.1.A, PG 13. QRTRLY SAMPLING INSTRUCTIONS - I.C.7, PG. 14. <br />EPA Form 3320.1 (Rev.01 /00) Previous editions may be used. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />004-A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM/DD/YYYY <br />10/1/2011 <br />MM /DD/YYYY <br />12/31/2011 <br />TO <br />DMR Mailing ZIP CODE: 81648 <br />MINOR <br />(SUBR DW) RBLAN <br />PP2 TO SCULLION GULCH <br />External Outfall <br />Form Approved <br />OMB No. 2040 -0004 <br />No Discharge <br />0 <br />0511112011 <br />Page 2 <br />