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PARAMETER <br />I Gently under penalty of law that dm document and all attachments were prepared under my direction or <br />sup•rvis n ccordancewith asy temdesignedtoassurethatqualifiedpersonnelproperlygatterand <br />I t t tn <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 />BOD, 5 -day, 20 deg. C <br />00310 G 0 <br />Raw Sewage Influent <br />SAMPLE <br />MEASUREMENT <br />AREA Code <br />NUMBER <br />• <br />, „ *t <br />TYPED OR PRINTED <br />PERMIT <br />REQUIREMENT <br />Req Mon <br />30DA AVG <br />Opt Mon <br />MX 7D AV <br />Ibid <br />Req Mon. <br />30DA AVG <br />Opt Mon. <br />MX 7D AV <br />mg /L <br />Monthly <br />GRAB <br />Solids, total suspended <br />00530 G 0 <br />Raw Sewage Influent <br />SAMPLE <br />MEASUREMENT <br />....., <br />sass.. <br />. >. >a. <br />...,.. <br />PERMIT <br />REQUIREMENT <br />Req Mon <br />30DA AVG <br />Opt Mon <br />MX 7D AV <br />mg /L <br />Monthly <br />GRAB <br />Flow, in conduit or thru treatment plant <br />50050 G 0 <br />Raw Sewage Influent <br />SAMPLE <br />MEASUREMENT <br />.sass. <br />,, — <br />PERMIT <br />REQUIREMENT <br />Req Mon. <br />30DA AVG <br />Req Mon. <br />DAILY MX <br />Mgal /d <br />Weekly <br />INSTAN <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />I Gently under penalty of law that dm document and all attachments were prepared under my direction or <br />sup•rvis n ccordancewith asy temdesignedtoassurethatqualifiedpersonnelproperlygatterand <br />I t t tn <br />/ <br />q <br />7 _ `— --” <br />• ��J L � ! - .,.( <br />TELEPHONE <br />DATE <br />l 3 r l � ^ <br />/ .._,f( <br />• <br />to he t tf nnanon submitted Based on my inquiry of the person or persons who manage the <br />system m tho4e persons directly responsible for gathenng the information the info rmanon submitted is <br />to the best of my knowled a and belief, inn., accurate, and complete I am aware that there are st ficanr <br />pemm�ec tor submitting talisc information, including me possibility of me and tmpnmnmcm for Anmsing <br />l t <br />t/ <br />v� x ` 7 � <br />L f <br />�. G <br />/� <br />t,/� ^� 't j' 1 `- <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code <br />NUMBER <br />• <br />MM /DDIYYYY <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 3320.1 (Rev.01106) 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 />300 -I <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD /YYYY <br />01/01/2012 <br />MMIDD/YYYY <br />03/31/2012 <br />TO <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />INFLUENT SAMPLES MUST BE COLLECTED, ANALYZED & REPORTED MONTHLY AND REPORTED QUARTERLY REGARDLESS OFWHETHER AN EFFLUENT DISCHARGE OCCURS. <br />DMR Mailing ZIP CODE: <br />MINOR <br />(SUBR JC) MOFAT <br />INFLUENT TO DOMESTIC WWTF <br />Influent Structure <br />Form Approved <br />OMB No 2040 -0004 <br />80467 -9704 <br />No Discharge <br />01/11/2012 Page 1 <br />