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PARAMETER <br />I comfy under penalty of law that this document and all attachments were prepared under my direcuon or <br />supervaton m accordance moth a system designed to assure that qualified personnel properly gather and <br />al <br />dust f hoe b ncd. Beard utqurry t the pert who manage rit <br />system, or r those persons d e responsible for or enndthe tma *o . thhe c e m t here here submitted rs. <br />to the best of my knowledge e and belief, true, accurate, and compleplete, e. I am am re awa that t are sigmficmt <br />penalties m g <br />orsubmngfalseInformatiom srbr <br />cludingtheposhty offin nt <br />eandunpruonentforlmowmg <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />E)( <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 />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />••• * *• <br />Weekly <br />VISUAL <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />I comfy under penalty of law that this document and all attachments were prepared under my direcuon or <br />supervaton m accordance moth a system designed to assure that qualified personnel properly gather and <br />al <br />dust f hoe b ncd. Beard utqurry t the pert who manage rit <br />system, or r those persons d e responsible for or enndthe tma *o . thhe c e m t here here submitted rs. <br />to the best of my knowledge e and belief, true, accurate, and compleplete, e. I am am re awa that t are sigmficmt <br />penalties m g <br />orsubmngfalseInformatiom srbr <br />cludingtheposhty offin nt <br />eandunpruonentforlmowmg <br />, <br />— ! /� LL <br />TELEPHONE <br />DATE <br />a.) ec. i A Pt✓ <br />976.�r <br />♦ 5�5, <br />) <br />D /� / /S�1i� <br />CJ ! 2 <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />PED OR PRINTED <br />AREA code <br />NUMBER <br />MM /DD/YYYY <br />PERMITTEE NAME/ADDRESS (include Facility Name/LocationifDifferent) <br />NAME: <br />ADDRESS: <br />FACILITY: <br />LOCATION: <br />Bowie Resources LLC <br />PO Box 483 <br />Paonia, CO 81428 <br />BOWIE NO. 2 MINE <br />5 MI NE OF TOWN ON CO HWY 133 <br />PAONIA, CO 81428 <br />ATTN: BRADLEY E. HANSON, VICE PRES. <br />ATION 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 />FROM <br />000044776 <br />PERMIT NUMBER <br />009A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM/DD/YYYY <br />99W6172009% <br />MM /DD/YYYY <br />-09/9012009 <br />TO <br />NJ <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 />