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PARAMETER <br />1 certdy under penalty of law that this document and all attachments were prepared under my direction or <br />supervision m accordance with a system designed to assure that quzheedpersonnel properly gather and <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 />Weekly <br />VISUAL <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />1 certdy under penalty of law that this document and all attachments were prepared under my direction or <br />supervision m accordance with a system designed to assure that quzheedpersonnel properly gather and <br />A " / ". 1f, - l- <br />`- <br />TELEPHONE <br />DATE <br />•/'� <br />r ' -,,,� / <br />11[/ ' I / <br />lu t th f t s b to .d B d y t q ty of the person or persons uho manag the <br />system, or those persons directly respoastble for gathering the mfonnanon, the Information submuted is, <br />to the best of my knowledge and belief, true, accurate, and complete 1 am aware that there are mg ficant <br />penalties for submitung false mformanon, including the possthility of fine and impnsonment for knowmg <br />vtolauons <br />/7 ` O /1� ^ <br />!% ' / <br />/ <br />/624/4.W3 <br />S IGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code <br />NUMBER <br />MM /DD/YYYY <br />PED OR PRINTED <br />PERMITTEE NAME /ADDRESS (Include Faci /ityName /Location 17Different) <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 />EPA Form 3320 -1 (Rev.01 /06) Previous editions may be used. <br />IV/11 IVINAL YVLLV 1HIV 1 tLIMINA I IUN SYJ 1 tM (NI'Ut5) <br />DISCHARGE MONITORING REPORT (DMR) <br />C00044776 <br />PERMIT NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />.09E44 .2ett9` <br />MM /DD/YYYY <br />FROM <br />/did /ao /1- <br />002A <br />DISCHARGE NUMBER <br />TO r09/313)2669— <br />/d- /3 ( /d-e/ <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />SR;DEER TRL DTC OR UNMD TRIB <br />External Outfall <br />corm 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.1.3, PG 9. QRTRLY SAMPLING INSTRUCTIONS- I.C.10, PG. 10. <br />Page 2 <br />