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PARAMETER <br />I certify under penalty of law that this document and all attachments were prepared under my dtrechon or <br />supernston rn accordance with a system dcsrgncd to assure that qualified personnel 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 />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 />I certify under penalty of law that this document and all attachments were prepared under my dtrechon or <br />supernston rn accordance with a system dcsrgncd to assure that qualified personnel properly gather and <br />( , / 1 <br />n <br />` <br />TELEPHONE <br />DATE <br />() -- <br />�rC 6< e j tr i�//4`2 K. <br />I t th f t sub Based mquny of the person persons who manage the <br />system. <br />system. r em, those persons ducctly re responsible le for or gathenng the Information, the md'ormaaon submrted rs, <br />to dte <br />penalises for summmg fa a Information, ncldung the os of f a d mpnaonment for know <br />"tomnnna. <br />2 e 4 7 � '� <br />( /�,/ <br />� " 13-6 / <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code <br />NUMBER <br />MM /DD/YYYY <br />l TYPED OR PRINTED <br />PERMITTEE NAME /ADDRESS (Include FaciiityName✓Location 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 />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />FROM <br />C00044776 <br />PERMIT NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />- 09#6442669 <br />MM /DD/YYYY <br />` -- <br />/I /i3 <br />002A <br />DISCHARGE NUMBER <br />TO <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.1.3, PG 9. QRTRLY SAMPLING INSTRUCTIONS- I.C.10, PG. 10. <br />EPA Form 3320 -1 (Rev.01 /06) Previous editions may be used. <br />Page 2 <br />