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PARAMETER <br />I certify under penalty of law that this document and all attachments were prepared under my direction or <br />supervision in accordance with a system designed to assure that qualified personnel properly gather and <br />1 t th • f t o b y re Based or athenn of the person information, persons who manage the <br />Inquiry • <br />system, or those persons d eany re hef, tr le ue, for urat enn the plete I m the information re sign w, <br />to the best of ub knowledge and information, tree, accurate. end mo bility 1 fine aware that there are significant <br />penalties for submitting false information, including the possibility of fine and rmpnsonment for knowing <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />E)( <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 />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 this document and all attachments were prepared under my direction or <br />supervision in accordance with a system designed to assure that qualified personnel properly gather and <br />1 t th • f t o b y re Based or athenn of the person information, persons who manage the <br />Inquiry • <br />system, or those persons d eany re hef, tr le ue, for urat enn the plete I m the information re sign w, <br />to the best of ub knowledge and information, tree, accurate. end mo bility 1 fine aware that there are significant <br />penalties for submitting false information, including the possibility of fine and rmpnsonment for knowing <br />/ , 4 'Z / <br />i ✓,(,�,L,a,'aih ' /a 1 1_ (/ C 1V�� <br />1 <br />TELEPHONE <br />DATE <br />►w/ C_�✓ ) T n �I <br />ID e <br />'?557 <br />�.�,P' /� / " <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />` <br />AREA Code <br />NUMBER <br />MM /DD/YYYY <br />TYPED OR PRINTED <br />PERMITTEE NAME/ADDRESS (Include Faciiity Name/Location if 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 />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 />009A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />09tQ7f2099 <br />MM /DD/YYYY <br />Sit IDovz <br />TO -99t39t2909 <br />513[1.)-0 <br />Form Approved <br />OMB No. 2040 -0004 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />SR DSCH /UNNMD TRIB /HUBBARD CRK <br />External Outfall <br />No Discharge <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SETTLEABLE SOLIDS LIMIT APPLIES ONLY IF <10YR/24HR PRECIP EVENT IS CLAIMED. IF CLAIM APPROVED BY WQCD,TSS 8 IRON LIMITS WILL NOT BE APPLIED TO RPTD MEASUREMENTS -SEE I.A.3,PG. 4 -5 FOR BURDEN OF <br />PROOFREQUIREMENTS. OIL & GREASE - I.B.1.3, PG. 9. QRTRLY SAMPLING INSTRUCTIONS - I.C.10, PG. 10. <br />Page 2 <br />