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PARAMETER <br />1 cemfy under penalty of law that this document and all attachments were prepared under my auction or <br />sup thatqualifiedpersonnelproperlygatherand <br />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 />Flow, in conduit or thru treatment plant <br />50050 G 0 <br />Raw Sewage Influent <br />SAMPLE <br />MEASUREMENT <br />a , I ()%' 730 <br />, 667 _ 1-2 <br />��// <br />K� <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />30DA AVG <br />Req. Mon. <br />DAILY MX <br />Mgal /d <br />•••••• <br />Continuous <br />RCORDR <br />Chlorine, total residual <br />50060 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />,,,,,, <br />• ( l <br />/-7 <br />(v- <br />REQUIREMENT <br />INST M AX <br />mg / <br />c <br />Weekly <br />GRAB <br />Solids, total dissolved <br />70295 1 0 <br />Effluent Gross <br />SAMPLE <br />.,,,,, *,*** <br />*; *x** <br />R***.* <br />L i . ) , ( <br />44 3i <br />430 <br />PERMIT <br />REQUIREMENT <br />*M.** <br />Req. Mon. <br />QRTR AVG <br />Req. Mon. <br />QRTR MAX <br />mg /L <br />Quarterly <br />GRAB <br />Coliform, fecal general <br />74055 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />.,,,,, <br />,,,,,, <br />6 <br />3:5) <br />'.3/40 <br />6 <br />RM MENT <br />REQUIREMENT <br />„ *,,, <br />0 <br />30DA AVG <br />1 0 0 <br />MX7DGEOA <br />#/100mL <br />Monthly <br />GRAB <br />Oil and grease visual <br />84066 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />0. <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 />1 cemfy under penalty of law that this document and all attachments were prepared under my auction or <br />sup thatqualifiedpersonnelproperlygatherand <br />f <br />/ <br />TELEPHONE <br />DATE <br />✓ <br />e taeri _ "r�� A I <br />`''' <br />at t th o tt b tt d B d y tinny f th p rso pe hh g th <br />to b or those persons dtra and responsible for enndthe complete I am the a that there suborned an <br />to the best of ub knowledge and rman true, accurate, and complete 1 am aware that there are r knowing <br />penalties for submitting false mformanon, mcludmg the posstbdtty of fuse and Imprisonment for Imowmg <br />vtolanona <br />/� 2Q - ? g/ - � <br />�!1 <br />1 A 1.3i)/0/21 <br />V <br />MM /DD/YYYY <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />/ <br />TYPED OR PRINTED <br />AREA Code NUMBER <br />PERMITTEE NAME/ADDRESS (Include FacilityName/Locabon if Different) <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 />LANATION OF ANY VIOLATIONS (Reference all attachments here) <br />OIL & GREASE - 1.B.1.E, PG. 9. QRTRLY SAMPLING INSTRUCTIONS - I.C.10, PG. 10. <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 />MM/DD/YYYY <br />FROM 00/01/2003 <br />4 / /CV /a0 f L <br />004A <br />DISCHARGE NUMBER <br />TO 6940/909 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />WWTF TO DEER TRAIL DITCH <br />External Outfall <br />Form Approved <br />OMB No. 2040 -0004 <br />No Discharge <br />Page 2 <br />