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PARAMETER <br />eemry und penatry law tt minmm an a' ,hmnh were prpd m dn <br />supen isron m accordanc e wrth em doLd desg In d al 'wart that e qualified peresonnel are un proper ly y gath er eenen and or <br />evaluate them nnatton submmed Based on my Inquiry of person or persons who manage th <br />or those persons directly responsible for gathenng the mfonnanon, the Information submnted h <br />w the best of my knowledge and belief, true, accurate, and complete 1 am awaic that there ere significant <br />penalties tor false information, mewamg mepobsibinry ot fine and tmpn sonm�nttor Urns <br />o a <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 />� <br />,, <br />V <br />(/ <br />7 <br />t S l/ .: <br />,,,,,, <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 />eemry und penatry law tt minmm an a' ,hmnh were prpd m dn <br />supen isron m accordanc e wrth em doLd desg In d al 'wart that e qualified peresonnel are un proper ly y gath er eenen and or <br />evaluate them nnatton submmed Based on my Inquiry of person or persons who manage th <br />or those persons directly responsible for gathenng the mfonnanon, the Information submnted h <br />w the best of my knowledge and belief, true, accurate, and complete 1 am awaic that there ere significant <br />penalties tor false information, mewamg mepobsibinry ot fine and tmpn sonm�nttor Urns <br />o a <br />-. <br />f _ - <br />r 1 L L G / t . / r. - �( ,_. / � ^J/ <br />TELEPHONE <br />DATE <br />/� / / G n `� l� r -/-� <br />ire <br />0. / I k-7,( L ., <br />(1 -7 -y'' 'o <br />! 0 v 7C L ��� <br />/// <br />�/� (' z L' / a <br />S IGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code I NUMBER <br />MM /DD/YYYY <br />TYPED OR PRINTED <br />PERMITTEE NAME /ADDRESS (Include Facility Name /Location if Different) <br />NAME: Moffat County Mining LLC <br />ADDRESS: 29515 Routt CR 27 <br />Oak Creek, CO 80467 -9704 <br />FACILITY: <br />LOCATION: <br />EAGLE MINE COMPLEX <br />1030 COUNTY ROAD 107 <br />CRAIG, CO 81626 <br />ATTN JERRY NETTLETON, ENV SUPERVISR <br />EPA Form 3320 (Rev.01 /06) Previous editions may be used. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />FROM <br />C00034142 <br />PERMIT NUMBER <br />022 -A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />01/01/2012 <br />M MID D/YYYY <br />03/31/2012 <br />TO <br />DMR Mailing ZIP CODE: 80467 -9704 <br />MINOR <br />(SUBR JC) MOFAT <br />SPOILS SP WTR &SEEP/WILLIAMS FK <br />External Outfall <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />FLOW LIMIT APPLIED TO COMBINED FLOW FROM 003, 022 & 024. OIL & GREASE GRAB SAMPLE ANALYSIS REQUIRED IFVISIBLE SHEEN IS OBSERVED. QRTRLYSAMPLING INSTRUCTIONS- I.C.12, PG. 9. <br />Form Approved <br />OMB No 2040 -0004 <br />No Discharge <br />01/11/2012 Page 2 <br />