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PARAMETER <br />1 unify under penal of law that this document and all attachments were prepared under my duecnon or <br />a y gne 9 personnel properly <br />alu t r rn accordance with a system d o d to assure that a son o I o 1 ether and <br />vale t the f h b n • Based or inquiry of the person ,them who Noa sub nage the <br />persons <br />system, or thou persons d responsr le true, f accurate, enn the complete. I o am the serf atro ig n o ted u, <br />Penalties for submitting false information, mslud g the possrbrl y of fmc and rmpnsonment for kr wing <br />vrolatons <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 />....., <br />....., <br />.,..,, <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />""'• <br />."'•• <br />Weekly <br />VISUAL <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />1 unify under penal of law that this document and all attachments were prepared under my duecnon or <br />a y gne 9 personnel properly <br />alu t r rn accordance with a system d o d to assure that a son o I o 1 ether and <br />vale t the f h b n • Based or inquiry of the person ,them who Noa sub nage the <br />persons <br />system, or thou persons d responsr le true, f accurate, enn the complete. I o am the serf atro ig n o ted u, <br />Penalties for submitting false information, mslud g the possrbrl y of fmc and rmpnsonment for kr wing <br />vrolatons <br />J(/ // //�(� ^ J��{�p/� �../I�. <br />/ ! ' f +_ 7GGV V <br />TELEPHONE <br />DATE <br />(� —� <br />DP (e> I°_ r 1 �A n e y <br />9 }�/j <br />( { <br />��/,�,{,�+�/ <br />!� - ' <br />�� (Doti <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code <br />NUMBER <br />MM /DD/YYYY <br />(J TYPED OR PRINTED <br />PERMITTEE NAME/ADDRESS (include Faci/ityName/Location ifDifferent) <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 />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 />C00044776 <br />PERMIT NUMBER <br />005A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM/DD/YYYY <br />Icuva <br />MM /DD/YYYY <br />-O84 -. <br />to( (av1).- <br />TO <br />100 <br />13 lac> <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 />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <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- I.B.1.E, PG 9. QRTRLY SAMPLING INSTRUCTIONS - I.C.10, PG. 10. <br />Page 2 <br />