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PARAMETER <br />Iceroty under penalty of law that this document and all attaihmenl > were prepnredundermydutttwnor <br />supervision in a nriance mail a sy.t nu designed to assure that qualified :(Id <br />aluale the information submitted Based on my inquiry of the person or person who manage the <br />sy m <br />stem those persons directly responsible for gathenng the information, the information submitted ,s <br />to the best of my knowledge and belief, true, accurate, and comphte I am aware that there are s,gntfica t <br />ngtalsc mcluJmgthe posabilnyot tine and ,mpn m <br />vo n submitting imprisonment tor <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 />%Effect Statre 7Day Chronic <br />Pimephales <br />TCP6C S 0 <br />See Comments <br />SAMPLE <br />MEASUREMENT <br />.,..,, <br />,., ><. <br />MMIDD/YYYY <br />7 t (; ( <br />TYPED OR PRINTED <br />L% <br />/qZ <br />C. '} <br />PERMIT <br />REQUIREMENT <br />Req. Mon <br />MN VALUE <br />Quarterly <br />GRAB - 3 <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />Iceroty under penalty of law that this document and all attaihmenl > were prepnredundermydutttwnor <br />supervision in a nriance mail a sy.t nu designed to assure that qualified :(Id <br />aluale the information submitted Based on my inquiry of the person or person who manage the <br />sy m <br />stem those persons directly responsible for gathenng the information, the information submitted ,s <br />to the best of my knowledge and belief, true, accurate, and comphte I am aware that there are s,gntfica t <br />ngtalsc mcluJmgthe posabilnyot tine and ,mpn m <br />vo n submitting imprisonment tor <br />J <br />/ _ �y <br />(. / <br />TELEPHONE <br />DATE <br />' { LL n <br />_ <br />U = h 0-Y'� <br />` � <br />, <br />2-7 <br />\' <br />Cr 1 <br />�� /� <br />f _ <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code <br />NUMBER <br />MMIDD/YYYY <br />TYPED OR PRINTED <br />PERMITTEE NAME /ADDRESS (Include Facility Name /Location if Different) <br />NAME: Twentymile Coal Co <br />ADDRESS: 29515 Routt CR 27 <br />Oak Creek, CO 80467 <br />FACILITY: <br />LOCATION: <br />FISH CREEK TIPPLE <br />29515 ROUTT COUNTY ROAD #27 <br />OAK CREEK, CO 80467 <br />ATTN: JERRY N. NETTLETON, ENV SUPVSR <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 />C00036684 <br />PERMIT NUMBER <br />001 -X <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />10/01/2011 <br />MM /DD/YYYY <br />12/31/2011 <br />TO <br />DMR Mailing ZIP CODE: 80467 <br />MINOR <br />(SUBR JC) ROUTT <br />CHRONIC WET TESTING FOR 001A <br />External Outfall <br />Form Approved <br />OMB No. 2040 -0004 <br />No Discharge <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SEE PART I.A 4 OF PERMIT FOR DETAILS OF TEST PROCEDURE. RPT LOWEST %AT WHICH STATISTICALLY SIGNIF DIFFBTWN TEST & CONT USING TEST CODE "S" RPT IC25 USING TEST CODE "P" ATTACH CHRONIC TOX <br />TEST RPT TO DMR. <br />07/27/2011 Page 2 <br />