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PARAMETER <br />I certify under penalty of law that this document and all attachments were prepared under my dumdum or <br />mpervts h m fc naafi c asystemd*n my =pry p erson dperso who properly <br />manage her and <br />evaluat the f naafi sub tied, Based 1* f or mqa su of the person ro person who n, the mforma manage dm <br />or <br />system, or those persons duectly responsible or gathenng the Information, subnutted u, <br />to the best of my knowkdgc and belief, true, accurate, and complete. I am aware that there are ugmBCant <br />permit,. for submdung false information, including the possrbddyoff andrmpnsonmentformmwmg <br />Wan n <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 />..,... <br />,,,... <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />« ««««« <br />« ««« «« <br />- <br />Weekly <br />VISUAL <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />I certify under penalty of law that this document and all attachments were prepared under my dumdum or <br />mpervts h m fc naafi c asystemd*n my =pry p erson dperso who properly <br />manage her and <br />evaluat the f naafi sub tied, Based 1* f or mqa su of the person ro person who n, the mforma manage dm <br />or <br />system, or those persons duectly responsible or gathenng the Information, subnutted u, <br />to the best of my knowkdgc and belief, true, accurate, and complete. I am aware that there are ugmBCant <br />permit,. for submdung false information, including the possrbddyoff andrmpnsonmentformmwmg <br />Wan n <br />�� ` <br />t17�'/ 1 <br />F y n <br />TELEPHONE <br />DATE <br />D e . 9V <br />/t ���s///��� <br />t,n, r1 � / -5;o) <br />a-9 - i '"Z <br />S IGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />l , <br />AREA Code NUMBER <br />MM /DD/YYYY <br />D OR <br />TYPED OR PRINTED <br />PERMITTEE NAME/ADDRESS (Include Facility Name/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 />000044776 <br />PERMIT NUMBER <br />MONITORING PERIOD <br />MM/DD/YYYY <br />8510112069. <br />MM /DD/YYYY <br />002A <br />DISCHARGE NUMBER <br />TO <br />i0/3/ 4 -01z <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.8.1.3, PG 9. QRTRLY SAMPLING INSTRUCTIONS- I.C.10, PG. 10. <br />Page 2 <br />