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PARAMETER <br />1 certify ider penalty of law that this document and all attachments were prepared under my direction m <br />supernsumin accordance with a r2mde21121221t0 tmgualhredpmwmelmoperly gathm <br />evaluate to information submitted. Based on my i nquiry of the person or penis wM manage the <br />system, m date pm o ddir`alyre.pormblefatasthma the information, the information submitted is, <br />;mg,1a ; , t ,4'r' e��. o 1=It f a <br />misstate. `t <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 />LC50 Static Renewal 48Hr Acute <br />Daphnia magna <br />TAM3C 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />..... <br />...... <br />...... <br />,,,,,• <br />,,,,,, <br />PERMIT <br />REQUIREMENT <br />"'•'• <br />""'"' <br />100 <br />MO AV MN <br />•••••• <br />•••••• <br />% <br />Quarterly <br />GRAB <br />LC50 Statre 96Hr Acute Pimephales <br />TAN6C 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />. „... <br />...... <br />. „.,, <br />..„,, <br />.•„„ <br />PERMIT <br />REQUIREMENT <br />•••�' <br />"••• <br />100 <br />MO AV MN <br />•••"• <br />'•*••' <br />% <br />Quarterly <br />GRAB <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />1 certify ider penalty of law that this document and all attachments were prepared under my direction m <br />supernsumin accordance with a r2mde21121221t0 tmgualhredpmwmelmoperly gathm <br />evaluate to information submitted. Based on my i nquiry of the person or penis wM manage the <br />system, m date pm o ddir`alyre.pormblefatasthma the information, the information submitted is, <br />;mg,1a ; , t ,4'r' e��. o 1=It f a <br />misstate. `t <br />TELEPHONE <br />DATE <br />Scott Wanstedt, Environmental Engineer <br />(970) 675 -4322 <br />01/09/2012 <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code I NUMBER <br />MM/DDIYYYY <br />TYPED OR PRINTED <br />PERMITTEE NAME/ADDRESS (include Facility Name/Location if Different) <br />NAME: Blue Mountain Energy Inc <br />ADDRESS: 3607 CR 65 <br />Rangely, CO 81648 <br />DESERADO MINE <br />3607 CR 65 <br />RANGELY, CO 81648 <br />FACILITY: <br />LOCATION: <br />ATTN: ALAN HILLARD, MINE MGR <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 />C00038024 <br />PERMIT NUMBER <br />004 <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM/DD/YYYY <br />10/1/2011 <br />MMIDD/YYYY <br />12/31/2011 <br />TO <br />DMR Mailing ZIP CODE: 81648 <br />MINOR <br />(SUBR DW) RBLAN <br />ACUTE WET TESTING FOR 004A <br />Extemal Outfall <br />Form Approved <br />OMB No. 2040 -0004 <br />No Discharge <br />0 <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SEE PART I.A.2, PG. 8 -10, FOR DETAILS OF TEST PROCEDURE. REPORT LC50- STATISTICAL POINT ESTIMATE WHICHIS LETHAL TO 50% OF TEST ORGANISMS, AND ATTACH ACUTE TOXICITY TEST REPORT FORM TO DMR. <br />05/11/2011 Page 1 <br />