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PARAMETER <br />l cemfy under penalty of law that thus document and all attachments were prepared under my direction or <br />su t ccordance x rih a system designed to assure that qualified personnel properly gather and <br />1 t th of t sub tt dB d y inquiry of the person or persons who manage the <br />system, or those persons directly responsible for gathenng the tnformaton, the information subnutted us, <br />to the best of my knowled ge and belief, tine, accurate and complete I am aware that there are significant <br />pe al es forsubmuttmgf ase information, including the posstb o ffine and rmpnsonment 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 />• ,. kk „ <br />" "" <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />•••••` <br />*• *•" <br />Weekly <br />VISUAL <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />l cemfy under penalty of law that thus document and all attachments were prepared under my direction or <br />su t ccordance x rih a system designed to assure that qualified personnel properly gather and <br />1 t th of t sub tt dB d y inquiry of the person or persons who manage the <br />system, or those persons directly responsible for gathenng the tnformaton, the information subnutted us, <br />to the best of my knowled ge and belief, tine, accurate and complete I am aware that there are significant <br />pe al es forsubmuttmgf ase information, including the posstb o ffine and rmpnsonment for knowing <br />!+ /_J �X�/ V l / t <br />TELEPHONE <br />DATE <br />y/ ,, <br />/ a f J JP /� 62i/- <br />q �J O• �//� y� /-' ^ <br />/ /(0- 5,25 <br />/ J�,/� <br />Q / !v0 <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />t / TYPED OR PRINTED <br />Ian <br />AREA Code NUMBER <br />r <br />MM /DD/YYYY <br />PERMITTEE NAME /ADDRESS (include FacilityName/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 />COMMENT 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 />MM /DD/YYYY <br />FROM %.A9/9 @@9 TO <br />009A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />oK13( <br />Form Approved <br />OMB No. 2040-0004 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />SR DSCH /UNNMD TRIB /HUBBARD CRK <br />External Outfall <br />No Discharge <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 RPTD MEASUREMENTS -SEE I.A.3,PG. 4 -5 FOR BURDEN OF <br />PROOFREQUIREMENTS. OIL & GREASE - I.B.1.3, PG. 9. QRTRLY SAMPLING INSTRUCTIONS - I.C.10, PG. 10. <br />Page 2 <br />