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PARAMETER <br />1 certq under penally of law that this document anti all attachments were prepared under my direuion or <br />supervision to accordance with a system designed to assure that qualified personnel properly gather and <br />• I t th • f n b tt •d B •d y q uy f th p pe h g th <br />system, or those persons &redly responsible for gathenng the Information, the information submitted is, <br />to the best of my knowledge and belief, true, accurate, and wmpletc t am aware that there are significant <br />penalties for submitting false mforman on, including the possibility of fine and impnsonment for knowing <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 />•••••• <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />•••••• <br />Weekly <br />VISUAL <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />1 certq under penally of law that this document anti all attachments were prepared under my direuion or <br />supervision to accordance with a system designed to assure that qualified personnel properly gather and <br />• I t th • f n b tt •d B •d y q uy f th p pe h g th <br />system, or those persons &redly responsible for gathenng the Information, the information submitted is, <br />to the best of my knowledge and belief, true, accurate, and wmpletc t am aware that there are significant <br />penalties for submitting false mforman on, including the possibility of fine and impnsonment for knowing <br />4 <br />L�� �-. ' <br />TELEPHONE <br />DATE <br />/�'' 1 ...'//�7 <br />�(w �j {/ � I�n,n r <br />r <br />7 �' .1 <br />• J <br />7 / <br />�/ <br />V 111 <br />S IGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />$ PED OR PRINTED <br />AREA Code <br />I NUMBER <br />MM /DD/YYYY <br />PERMITTEE NAME/ADDRESS (Include FacilityName/Location "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 />COMMENTS 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 />MONITORING PERIOD <br />MM /DD/YYYY <br />MM /DD/YYYY <br />FROM 09/01/2009 -- <br />4,/, f!r� <br />007A <br />DISCHARGE NUMBER <br />TO 00/30/2000 <br />Form Approved <br />OMB No. 2040 -0004 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MN) DELTA <br />DSCHG OF SR TO GUNNISON RIVER <br />External Outfall <br />No Dischar <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 />