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PARAMETER <br />1 Leda) under penalty of law that this dowmcnt and all atmihments wan nd under m Jireuion or <br />supervision uxJun tllnasyst rnJevgnsdmassurcthatquahfi d p rso gathuand <br />1. <br />II , ,t u orn It « with red Based on m) inquiry of person or persons who manage the <br />system of most person hiccup re pent t blc for irat cru Ilia information rmatmn the information r s i gn M n. <br />to the best of my AnnwleJge and belief, we, acuirate, and complsie 1 am aware chat then arc vigndieaN <br />alsforcubmatmgtake information including the possibility of tine and imprisonment for Annum <br />v ol o c o <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 />- c. <br />G <br />(' <br />Z <br />Z lt <br />PERMIT <br />REQUIREMENT <br />100 <br />MN VALUE <br />Quarterly <br />GRAB - 3 <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />1 Leda) under penalty of law that this dowmcnt and all atmihments wan nd under m Jireuion or <br />supervision uxJun tllnasyst rnJevgnsdmassurcthatquahfi d p rso gathuand <br />1. <br />II , ,t u orn It « with red Based on m) inquiry of person or persons who manage the <br />system of most person hiccup re pent t blc for irat cru Ilia information rmatmn the information r s i gn M n. <br />to the best of my AnnwleJge and belief, we, acuirate, and complsie 1 am aware chat then arc vigndieaN <br />alsforcubmatmgtake information including the possibility of tine and imprisonment for Annum <br />v ol o c o <br />/ (/, / ✓ ��� <br />1 Gt /' Y (.' 1 <br />"""" <br />TELEPHONE <br />DATE <br />' f � <br />,y i I 1 ' �. � Y S C <br />G 1 <br />11!! / <br />-7y -+� <br />` v ./e :2_7 J�� <br />�/ <br />0 I /� ' Z C <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />TYPED OR PRINTED <br />AREA Code I NUMBER <br />MM /DD/YYYY <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 />S (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 />C00036684 <br />PERMIT NUMBER <br />01 Y -X <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />10/01/2011 <br />M M/D D/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 />SEE I A.4 FOR DETAILS OF TEST PROCEDURE. IF THERE IS A STAT DIFF RPTRESULTS ON THIS OUTFALL. IF NOT,RPT "NO DISCHARGE" & COMPLETE OUTFALL 001X RPT LOWEST % AT WHICH STATISTICALLY SIGNIF DIFF <br />BETWEEN TEST& CONT USING TEST CODE "S" RPT IC25 USING TEST CODE "P" ATTACH CHRON TOX TEST RPT TO DMR. <br />07/27/2011 Page 2 <br />