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PARAMETER <br />l cemfy under penalty of law that tins document and all attachments were prepared under my direction or <br />sapervrsron m accordance vnth a system designed to assure that quahfied personnel properly gather and <br />f <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 />.«... <br />1/--) <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />Weekly <br />VISUAL <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />l cemfy under penalty of law that tins document and all attachments were prepared under my direction or <br />sapervrsron m accordance vnth a system designed to assure that quahfied personnel properly gather and <br />f <br />!!! 000111��ffWll'��1 <br />f oliYl.VI <br />TELEPHONE <br />DATE <br />PwLo 40llo✓ <br />e alu t th rmat o sub tt d. B d y gmry f th pe pens wh g th <br />system, or those persons directly directly ro hef, true, roc accurate, and complete I am , the aware information that the <br />to the best of my re arc submitted can t <br />knowledge alief, tuc uratd them ec t am thre mttted <br />vo l a no�orsubmrung false mfomuoogmcludngthe possrbtlrryoffinemdrmpnsoment for knowmg <br />9 70, 9 5 <br />7 <br />91b0/4"1-- <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />PED OR PRINTED <br />AREA Code NUMBER <br />MM /DD/YYYY <br />PERMITTEE NAME/ADDRESS (Include FacilityName/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 />F ANY VIOLATIONS (Reference all attachments here) <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 />001A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />12/01/4009. <br />Poi <br />MM/DD/YYYY <br />TO 12/31/200a <br />0 S° // <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />SR/MINE WTR TO DEER TRAIL DTCH <br />External Outfall <br />Form Approved <br />OMB No. 2040-0004 <br />No Discharge n <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- I.B.1,3, PG 9. QRTRLY SAMPLING INSTRUCTIONS- I.C.10, PG. 10. <br />Page 2 <br />