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PARAMETER <br />I certify under penalty of law that tins document and all attachments were prepared under mydueanonor <br />ry <br />supew m on fccordance with a system designed to ensure that p on perso properly gather and <br />aluat th C n b tied Based on my mquvy of the perer or <br />son or persons ns who manage the <br />system, or those persons directly responsible for gathenng the mfomtanon, the mfom,anon submitted is, <br />to the best of my knowledge anal belief, We, accurate, and complete. I am aware that there are significant <br />prnH�e� for submrtWgfelse tutotmanaq mcludmg the possibility offine and tmpnsoameat for kaowmg <br />no <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />dg <br />z <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 />PERMIT <br />REQUIREMENT <br />•••'•• <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />`•**•• <br />�••••• <br />Weekly <br />VISUAL <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />I certify under penalty of law that tins document and all attachments were prepared under mydueanonor <br />ry <br />supew m on fccordance with a system designed to ensure that p on perso properly gather and <br />aluat th C n b tied Based on my mquvy of the perer or <br />son or persons ns who manage the <br />system, or those persons directly responsible for gathenng the mfomtanon, the mfom,anon submitted is, <br />to the best of my knowledge anal belief, We, accurate, and complete. I am aware that there are significant <br />prnH�e� for submrtWgfelse tutotmanaq mcludmg the possibility offine and tmpnsoameat for kaowmg <br />no <br />TELEPHONE <br />t <br />DATE <br />.� <br />r j �f <br />eW e j Q� /[ <br />/C � w <br />/ /� //f r � L/ <br />/ ^ <br />�- <br />/ /' l ` / &, <br />/ 1/ /� (/ <br />V• .. ) <br />PED OR PRINTED <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT AREA code <br />NUMBER <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 />LATIONS (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 />MONITORING PERIOD <br />MM /DD/YYYY <br />09i94118tg' <br />MM /DD/YYYY <br />FROM <br />//5//)/2.- <br />002A <br />DISCHARGE NUMBER <br />TO f9f3e720139 <br />9/43 1— <br />No diae-la-7 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />SR;DEER TRL DTC OR UNMD TRIB <br />External Outfall <br />Form Approved <br />OMB No. 2040 -0004 <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 REPORTED MEASUREMENTS -SEE I.A.3, PP 4 -5 FOR <br />BURDEN OF PROOFREQUIREMENTS. OIL & GREASE - 1.6.1.3, PG 9. QRTRLY SAMPLING INSTRUCTIONS- I.C.10, PG. 10. <br />Page 2 <br />