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PARAMETER <br />1 certify under penalty of law that this document and all attachments were prepared under my dveu,on or <br />supervision m ccordance system designed to assure that qualified personnel properly gather and <br />al t 0 f t b ndBad y g ry ftt p tx I y th <br />system, best or those persons ducally sp ,true, for edge and belief, true, accurate, and the complete plete I a the aware mf that submitted <br />m t those knowledge owluratd plete 1 am that ther is <br />to i are m,gmed a <br />penal tieesstorsubmnimgfalseinformatron,, nclud, ngtheposs, bd ,ryoffineandunpnsonmentforkoonmg <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 />6 <br />„ <br />” "" <br />" "" <br />������ <br />/) <br />C• <br />K.7 <br />V(.S U C <br />PERMIT <br />REQUIREMENT <br />` ";" <br />Req. Mon. <br />INST MAX <br />Y=1 :N=0 <br />Weekly <br />VISUAL <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFIC <br />1 certify under penalty of law that this document and all attachments were prepared under my dveu,on or <br />supervision m ccordance system designed to assure that qualified personnel properly gather and <br />al t 0 f t b ndBad y g ry ftt p tx I y th <br />system, best or those persons ducally sp ,true, for edge and belief, true, accurate, and the complete plete I a the aware mf that submitted <br />m t those knowledge owluratd plete 1 am that ther is <br />to i are m,gmed a <br />penal tieesstorsubmnimgfalseinformatron,, nclud, ngtheposs, bd ,ryoffineandunpnsonmentforkoonmg <br />TELEPHONE <br />DATE <br />I ` <br />'` y �. <br />43r( t/ry bdet t 1 Y' ✓. V - <br />(t G - <br />�� <br />l <br />V <br />9 7 Q ,v / /f z ?0 <br />Q / z 7/( <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />TYPED OR PRINTED <br />AREA Code NUMBER <br />MMIDDIYYYY <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 />003 -A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />01/01/2012 <br />MM /DD/YYYY <br />03/31/2012 <br />TO <br />Form Approved <br />OMB No 2040 -0004 <br />DMR Mailing ZIP CODE: 80467 -9704 <br />MINOR <br />(SUBR JC) MOFAT <br />NO. 6 MINE TO WILLIAMS FORK RV <br />External Outfall <br />No Discharger <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 />01/11/2012 Page 2 <br />