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PARAMETER <br />I Lenin under penalty of that his doeument and all attachments were prepared under my dtreetton or <br />supers onn, n, sa, ordaneew m designed to assure that quabeed personnel properly gather and <br />valuate the information submitted Based on my inquiry of the person or persons who manage the <br />system, or those persons directly responsible for gnthenng the information the information submitted is, <br />to the best of my knowledge and belief, true, accurate, and complete re I am aware that the are significant <br />penalties tot submmmg false information, including the pis >tbmty of line and imprisonment for know <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 />%Effect Statre 7Day Chronic <br />Pimephales <br />TCP6C S 0 <br />See Comments <br />SAMPLE <br />MEASUREMENT <br />...... <br />...... <br />...... <br />...... <br />...... <br />PERMIT <br />REQUIREMENT <br />" ".` <br />"{"' <br />.. -- <br />Req Mon. <br />MN VALUE <br />'' "" <br />" "" <br />Quarterly <br />GRAB -3 <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />I Lenin under penalty of that his doeument and all attachments were prepared under my dtreetton or <br />supers onn, n, sa, ordaneew m designed to assure that quabeed personnel properly gather and <br />valuate the information submitted Based on my inquiry of the person or persons who manage the <br />system, or those persons directly responsible for gnthenng the information the information submitted is, <br />to the best of my knowledge and belief, true, accurate, and complete re I am aware that the are significant <br />penalties tot submmmg false information, including the pis >tbmty of line and imprisonment for know <br />'— <br />TELEPHONE <br />DATE <br />t \ <br />•ti ,) fi L e'1 t t <br />j <br />r l � . <br />- i 4 • 1 U , G <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code I 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 />001 -X <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />1DID1J2O44 <br />MM /DD/YYYY <br />12/320.1 -1 -- - <br />TO <br />DMR Mailing ZIP CODE: 80467 <br />MINOR <br />(SUBR JC) ROUTT <br />CHRONIC WET TESTING FOR 001A <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 />SEE PART I A 4 OF PERMIT FOR DETAILS OF TEST PROCEDURE RPT LOWEST %AT WHICH STATISTICALLY SIGNIF DIFFBTWN TEST & CONT USING TEST CODE "S" RPT IC25 USING TEST CODE "P ".ATTACH CHRONIC TOX <br />TEST RPT TO DMR <br />07/27/2011 Page 2 <br />