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PARAMETER <br />I yet-idly under penalty of that this doyument and all attachments were prepared under my direction or <br />supervtsm in <br />saluatc the information submitted Based on my inquiry of the person or persons who manage the <br />system, f tcm, or those persons directly responsible r gathering the information, the Information submitted is <br />to the but of my knowledge and belief, true, accurate, and wmple4 I am aware that there arc stgmf sari <br />pynalties <br />o amns <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 />Manganese, potentially dissolvd <br />01319 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />--- <br />2 (� <br />G c� <br />0 <br />j i <br />Cs. t".y <br />„,.,, <br />,.«., <br />PERMIT <br />REQUIREMENT <br />” "" <br />Req. Mon. <br />30DA AVG <br />Req. Mon <br />DAILY MX <br />ug /L <br />Monthly <br />GRAB <br />Nickel, potentially dissolvd <br />01322 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br /><_,..< <br />'C 2_c <br />; <br />1 ", L? <br />PERMIT <br />REQUIREMENT <br />" "" <br />Req Mon <br />30DA AVG <br />Req. Mon. <br />DAILY MX <br />ug /L <br />Monthly <br />GRAB <br />Selenium, potentially dissolvd <br />01323 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />>. <br />...... <br />� a <br />2 C' <br />., � <br />_<____ <br />PERMIT <br />REQUIREMENT <br />" "" <br />Req. Mon. <br />30DA AVG <br />Req Mon. <br />DAILY MX <br />ug /L <br />Monthly <br />GRAB <br />Mercury, total (as Hg) <br />71900 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />...... <br />..,... <br />,,.... <br />CG` • c� <br />+ <br />CI . �- <br />0 <br />G <br />I^ <br />at' o; h <br />PERMIT <br />REQUIREMENT <br />" "" <br />Req. Mon. <br />30DA AVG <br />Req. Mon. <br />DAILY MX <br />ug /L <br />Monthly <br />GRAB <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />I yet-idly under penalty of that this doyument and all attachments were prepared under my direction or <br />supervtsm in <br />saluatc the information submitted Based on my inquiry of the person or persons who manage the <br />system, f tcm, or those persons directly responsible r gathering the information, the Information submitted is <br />to the but of my knowledge and belief, true, accurate, and wmple4 I am aware that there arc stgmf sari <br />pynalties <br />o amns <br />. <br />� � - A <br />� y �` <br />TELEPHONE <br />DATE <br />,t J ` �� {� <br />4 t (j ) <br />//( �- <br />_ <br />.� ' / t <br />� <br />' 6 ✓ ) �/� CC 1 <br />( "'M tV p� i1 t/ I., , t * <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code NUMBER <br />/ <br />MM /DD/YYYY <br />TYPED OR PRINTED <br />PERMITTEE NAME /ADDRESS (Include Facility Name /Location If Different) <br />NAME: Twentymile Coal Co <br />ADDRESS: 29515 Routt CR 27 <br />Oak Creek, CO 80467 <br />FACILITY: <br />LOCATION: <br />FISH CREEK TIPPLE <br />29515 ROUTT COUNTY ROAD #27 <br />OAK CREEK, CO 80467 <br />ATTN JERRY N. NETTLETON, ENV SUPVSR <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 />C00036684 <br />PERMIT NUMBER <br />MM /DD/YYYY <br />0'/01 /2012 <br />`/ <br />MON -1 <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />TO <br />MM /DD/YYYY <br />t ` //2012 <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />AFTER 12 MONTHLY SAMPLES HAVE BEENTAKEN, PERMITTEE MAY REQUIEST THATA REASONABLE POTENTIAL ANALYSIS BECONDUCTED <br />DMR Mailing ZIP CODE: 80467 <br />MINOR <br />(SUBR JC) ROUTT <br />POND "E" DISCHARGE TO FISH CRK <br />External Outfall <br />Form Approved <br />OMB No 2040 -0004 <br />No Discharger <br />07/27/2011 Page 2 <br />