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PARAMETER <br />l certify under penalty of law that this document and all attachments were prepared under my direction or <br />supe sioninaccordancewi thasystemdesignedtoassurethatqualifiedpersonnelproper lygatherand <br />s .•,.,„,• th fo t o submitted rl Based le or mquvy of the person persons who manage the <br />system, <br />to the b st those persons d ray <br />e a n d responsible for gathering the mlete io Ia n, the a tbn <br />there re sigi fi is, <br />the best of my knowledge and belief, true, ecwrate, and wmpletc 1 am aware that there am significant <br />pe u lt.f orsubmntmgfalsemformanon, rncl udingthepossibrhty offineandrmpnsonmentforknowmg <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 />" " " "," <br />t " " " "" <br />, ", " "" <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />i - <br />Weekly <br />VISUAL <br />NAMEfrITLE PRINCIPAL EXECUTIVE OFFICER <br />l certify under penalty of law that this document and all attachments were prepared under my direction or <br />supe sioninaccordancewi thasystemdesignedtoassurethatqualifiedpersonnelproper lygatherand <br />s .•,.,„,• th fo t o submitted rl Based le or mquvy of the person persons who manage the <br />system, <br />to the b st those persons d ray <br />e a n d responsible for gathering the mlete io Ia n, the a tbn <br />there re sigi fi is, <br />the best of my knowledge and belief, true, ecwrate, and wmpletc 1 am aware that there am significant <br />pe u lt.f orsubmntmgfalsemformanon, rncl udingthepossibrhty offineandrmpnsonmentforknowmg <br />/ I I A (� / , <br />l / I /l./�►,�w'i/1 ' 'S 1! / �� S/lj <br />�/1 <br />TELEPHONE <br />DATE <br />P(0 ." 1 - 4, n h &v <br />///�li <br />nn <br />y' <br />I <br />2 251.15 - 6-0 <br />MM /DD /YYYY <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />_ <br />.LC) <br />TYPED OR PRINTED <br />AREA Code <br />NUMBER <br />NUMBER <br />PERMITTEE NAME/ADDRESS (Include FacilityName/Location "Different) <br />NAME: <br />ADDRESS: <br />FACILITY: <br />LOCATION: <br />Bowie Resources LLC <br />PO Box 483 <br />Paonia, CO 81428 <br />BOWIE NO. 2 MINE <br />5 MI NE OF TOWN ON CO HWY 133 <br />PAONIA, CO 81428 <br />ATTN: BRADLEY E. HANSON, VICE PRES. <br />ND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <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 />C00044776 <br />PERMIT NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />69/01720M' <br />MM /DD/YYYY <br />003A <br />DISCHARGE NUMBER <br />TO 03/30/2003 <br />1� Asa rZ <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />SR;DEER TRL DTC OR UNMD TRIB <br />External Outfall <br />Form Approved <br />OMB No. 2040 -0004 <br />No Discharge El <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 />