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PARAMETER <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 />1 14- <br />V q I_ <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />» » » » »» <br />« « » « «» <br />» » » » »» <br />Twice Per <br />Month <br />VISUAL <br />PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different) <br />NAME: Chevron Mining Inc <br />ADDRESS: 116 Inverness Dr E Ste 207 <br />Englewood, CO 80112 <br />FACILITY: EDNA MINE <br />LOCATION: 26990 COLORADO HWY 131 <br />OAK CREEK, CO 80467 <br />ATTN: Jim Tarazoff, Land Mgr <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />,M-vo PAt ee ea..0(DF t-C-EO <br />TYPED OR PRINTED <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 />C00032638 <br />PERMIT NUMBER <br />I certify under penalty of low that this document and all attachment, were prepared under my direction or <br />supervision to accordance meth n system designed to assure Ilan qualified personnel properly gather and <br />evaluate the Information submitted Based on my inquiry of the person or persons who mange the <br />system, or those person directly responsible far gathering the information, the information submmed it. <br />m the test of ms lnowled a and belief, true, accurate. and complete. I em aware that there are significant <br />penalties for suhnutung false information, including the possibility of 6n and tmpnsonntent for flowing <br />vminbun <br />007 -A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />09/01/2012 <br />MM /DD/YYYY <br />09/30/2012 <br />TO <br />SIGNATURE <br />PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SETTLEABLE SOLIDS LIMIT WILL BE WAIVED FOR >10YR,24HR PRECIP EVENT- SEE I.A.3, PG. 4, FOR REQUIREMENTS.QRTRLY SAMPLING INSTRUCTIONS - I.C.10, PG. 9. <br />DMR Mailing ZIP CODE: 80112 <br />MINOR <br />ROUTT <br />DSCHG TO KOLL DITCH #3 /TROUT CR <br />External Outfail <br />303 q36 - <br />AREA Code <br />TELEPHONE <br />NUMBER <br />Form Approved <br />OMB No. 2040 -0004 <br />No Discharge <br />DATE <br />22- 2 -a 2- <br />MM/DD <br />07/30/2012 Page 2 <br />