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PARAMETER <br />I certify under penalty oflaw that this document andall att achmentawerepreparedundermydireenonor <br />supervision in accordance with a system desngned to assure that qualified personnel properly gather and <br />lust lb f n b nod. Based on my inquiry of the person or persons who manage the <br />system, or those persons directly responsible for gathering the information, the information submitted is, <br />}o the best of my knowledge and belief, true, accurate, and complete 1 am aware that there are srgmfi • t <br />n lattons£ rsubmmmngfalscinformation, includingthepossnbdnryo ffeandimprisonmentfrknewmg <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 />I <br />J <br />,..... <br />....a, <br />,t.. <> <br />.. <_., <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />r- <br />Weekly <br />VISUAL <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />I certify under penalty oflaw that this document andall att achmentawerepreparedundermydireenonor <br />supervision in accordance with a system desngned to assure that qualified personnel properly gather and <br />lust lb f n b nod. Based on my inquiry of the person or persons who manage the <br />system, or those persons directly responsible for gathering the information, the information submitted is, <br />}o the best of my knowledge and belief, true, accurate, and complete 1 am aware that there are srgmfi • t <br />n lattons£ rsubmmmngfalscinformation, includingthepossnbdnryo ffeandimprisonmentfrknewmg <br />TELEPHONE <br />DATE <br />/] �O <br />(� / <br />- ,.. ,� M <br />1 <br />/,.,, <br />1,36 d <br />/� <br />1' \ <br />U <br />1'a n fl e <br />! • C <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code <br />NUMBER <br />MM /DD/YYYY <br />I <br />J <br />TYPED OR PRINTED <br />PERMITTEE NAME /ADDRESS (Include Facility Name/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 />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 />FROM <br />C00044776 <br />PERMIT NUMBER <br />003A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />00/0.1 /000 <br />MM /DD/YYYY <br />- 179f3 0/20Ga <br />l 0 /a- « z_ <br />TO <br />6 /301)iZ <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 <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 & 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 />