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PARAMETER <br />1 comfy under penalty of law that tits document and all attachments were prepared under my dueaton o <br />supen iston m accordance a gh a system destgncd to assure that qualified personnel properly gather an <br />1 f <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 />„t * ** <br />'11* <br />"" <br />PERMIT <br />REQUIREMENT <br />eqq Mon. <br />17% ST MAX <br />Y =1;N =0 <br />**H.. <br />Weekly <br />VISUAL <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />1 comfy under penalty of law that tits document and all attachments were prepared under my dueaton o <br />supen iston m accordance a gh a system destgncd to assure that qualified personnel properly gather an <br />1 f <br />- <br />-- <br />/ . ✓ l <br />TELEPHONE <br />DATE <br />e D ti A <br />t th to ub tt•d B d y quay fth p p• h gc the <br />on, the Information submitted <br />system, or those persons dveand ehof, truce accurate responsible for urate n and complete 1 aware that there are signific <br />to the best of my knowledge *o t <br />and r urate d ple un an <br />penalties forsubmittmgf alsemrm <br />foanoo, including the possibthty o f fine and impnsonmentfor knowing <br />/� /t.) . <br />( <br />" <br />y <br />r' /a) /act <br />( JC ) <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />PRINTED <br />YPED OR PRRINTED <br />i. <br />AREA Code <br />NUMBER <br />MM /DD/YYYY <br />PERMITTEE NAME /ADDRESS (include Faci/ityName/Location ifaferent) <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 />eference all attachments here) <br />EPA Form 3320 -1 (Rev.01106) 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 />002A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />09/F)099- <br />MM /DD/YYYY <br />- -08/3012 -008_. <br />TO <br />- 3i Z <br />Form Approved <br />OMB No. 2040 -0004 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />SR;DEER TRL DTC OR UNMD TRIB <br />External Outfall <br />No Dischargey/ ( <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.1.3, PG 9. QRTRLY SAMPLING INSTRUCTIONS- I.C.10, PG. 10. <br />Page 2 <br />