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PERMITTEE NAME /ADDRESS <br />NAME: MOUNTAIN COAL COMPANY, LLC <br />ADDRESS: WEST ELK MINE <br />P.O. BOX 591 <br />SOMERSET CO 81434 <br />FACILITY: WEST ELK MINE <br />LOCATION: APPX 1 MI E OF TOWN ON HWY 133 <br />SOMERSET, CO 81434 <br />ATTN: EUGENE E. DICLAUDIO, PRESIDENT. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCH ARGE MONITORING REPORT (DMR) <br />000038776 —� 011 W ACUTE WET TESTING FOR 011A <br />PERMIT NUMBER DISC N UMBER (SUBR MH) MNTRS <br />EXTERNAL OUTFALL <br />MONITORING PERIOD IMINOR <br />FROM 4/112012 To 1 6/30/2017 1 NO DISCHARGE <br />NOTE Read Instructions before completing this form <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) Forms by WlndowChem (707)864- 0845,p/n 11090.v5 0,1/1/96 <br />SEE I.A.5, PP. 6 -7, FOR DETAILS OF TEST PROCEDURE. REPORT LC50 - STATISTICAL POINT ESTIMATE WHICH IS LETHAL TO 50% OF THE TEST ORGANISMS, AND ATTACH ACUTE TOXICITY <br />TEST REPORT FORM TO DMR. <br />00105/980409 -1716 PAGE 1 OF 1 <br />QUALITY OR LOADING QUALITY OR CONCENTRATION <br />PARAMETER <br />NO. <br />FREQUENCY <br />SAMPLE <br />>< VALUE VALUE UNITS VALUE VALUE VALUE UNIT <br />SAMPLE <br />MEASUREMENT (23) <br />EX <br />OF <br />A NALYSIS <br />TYPE <br />LC50 STATRE 48HR ACU <br />DAPHNIA MAGNA <br />TAM3C 1 0 <br />EFFLUENT GROSS SEE COMMENTS <br />PERMIT <br />REQUIREMENT PERCENT <br />M 23 SAMPLE NO DISCHARGE <br />MEASUREMENT ) <br />QTRLY <br />GRAB <br />LC50 STATRE 96HR ACU <br />PIMEPHALES <br />TAN6C 1 0 EFFLUENT <br />GROSS <br />PERMIT <br />REQUIREMENT PERCENT <br />QTRLY <br />GRA6 <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER TELEPHONE <br />D A T E <br />I CERTIFY UNDER PENALTY OF LAW THAT THIS DOCUMENT AND ALL ATTACHMENTS WERE PREPARED UNDER MY <br />DIRECTION OR SUPERVISION IN ACCORDANCE WITH A SYSTEM DESIGNED TO ASSURE THAT QUALIFIED PERSONNEL <br />PROPERLY GATHER AND EVALUATE THE INFORMATION SUBMITTED BASED ON MY INQUIRY OF THE PERSON OR <br />PERSONS WHO MANAGE THE SYSTEM OR THOSE PERSONS DIRECTLY RESPONSIBLE FOR GATHERING T4E <br />INFORMATION, THE INFORMATION SUBMITTED IS TO THE BEST OF MY KNOWLEDGE AND BELIEF TRUE ACCURATE <br />Weston Norris AND COMPLETE I AM AWARE THAT THERE ARE SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION SIGNATURE OF PRINCIPAL EXECUTIVE 970 - 929 -5015 <br />INCLUDING THE P05SIBILITY OF FINE AND IMPRISONMENT FOR KNOWING VIOLATIONS <br />7/24/2012 <br />MM /DD/YYYY <br />TYPED OR PRINTED OFFICER OR AUTHORIZED AGENT <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) Forms by WlndowChem (707)864- 0845,p/n 11090.v5 0,1/1/96 <br />SEE I.A.5, PP. 6 -7, FOR DETAILS OF TEST PROCEDURE. REPORT LC50 - STATISTICAL POINT ESTIMATE WHICH IS LETHAL TO 50% OF THE TEST ORGANISMS, AND ATTACH ACUTE TOXICITY <br />TEST REPORT FORM TO DMR. <br />00105/980409 -1716 PAGE 1 OF 1 <br />