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PARAMETER <br />I certify under penalty of law that thus document and all attachments were prepared under m duauon or <br />super, monin accordance with a system designed to assure that quahfued personnel properlygather and <br />• I • • f <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 />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 />I certify under penalty of law that thus document and all attachments were prepared under m duauon or <br />super, monin accordance with a system designed to assure that quahfued personnel properlygather and <br />• I • • f <br />iC//l / <br />TELEPHONE <br />DATE <br />�W P (0 ^ o n e r <br />I (� <br />t th t sub tt • 8 d y quay fth• p perm h g th <br />system, or n o dg an b <br />ed responsible numb, a for the the a that there t of m knowledge <br />to the best of d beli true, l u re nd complete am am aware that are re sign canan t <br />penations. rsub mfitting ittmgfals an alsc information, on, n, mcludmg t t a he possibrety lete buLty offinc and wpnsonm onment for r kno lmowmg <br />violations. <br />( � ( J L}.)C <br />90 .� - . -" 5? <br />l <br />6 5 / / 2 <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />TYPED OR PRINTED <br />AREA Code <br />NUMBER <br />r <br />MM /DD/YYYY <br />PERMITTEE NAME/ADDRESS (Include FacihtyName/Location if Different) <br />NAME: Bowie Resources LLC <br />ADDRESS: PO Box 483 <br />Paonia, CO 81428 <br />FACILITY: BOWIE NO. 2 MINE <br />LOCATION: 5 MI NE OF TOWN ON CO HWY 133 <br />PAONIA, CO 81428 <br />ATTN: BRADLEY E. HANSON, VICE PRES. <br />AND EXPLANATION OF ANY VIOLATIONS (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 />C00044776 <br />PERMIT NUMBER <br />MM /DD/YYYY <br />FROM TO <br />// d91612QQJ` <br />Dot /01 ?°/ <br />008A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />©4 o lae. <br />Form Approved <br />OMB No. 2040 -0004 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />DSCGH OF SR TO GUNNISON RIVER <br />External Outfall <br />No Discharge /rn <br />SETTLEABLE SOLIDS LIMIT APPLIES ONLY IF <10YR,24HR PRECIP EVENT IS CLAIMED. IF CLAIM APPROVED BY WQCD,TSS & IRON LIMITS WILL NOT BE APPLIED TO REPORTED MEASUREMENTS -SEE I.A.3, PP 4 -5 FOR <br />BURDEN OF PROOFREQUIREMENTS. OIL & GREASE- I.B.1.E, PG 9. QRTRLY SAMPLING INSTRUCTIONS- I.C.10, PG. 10. <br />Page 2 <br />