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PARAMETER <br />1 certify under penalty of law that this document and all attachments were prepared under m direction or <br />wpemsronin accordance with a system designed to assure that qualifiedpersonnel properlygather and <br />evaluate th formation submitted. Based on my inquiry of the person or persons who anage the <br />system, or those o persons directly belief, for enn the information, the a that h submitted is, <br />to W and ete am aware that there are ailcant <br />e best of m knowledge and behef, tine, e, accurate, and tete I am compp gn <br />penalties for submitting false information, including the posnbihty of f e and impnwnmrnt for knowing <br />violations. y <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 />...Ir. <br />.,,,.. <br />....._ <br />...... <br />...... <br />l <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />Weekly <br />VISUAL <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />1 certify under penalty of law that this document and all attachments were prepared under m direction or <br />wpemsronin accordance with a system designed to assure that qualifiedpersonnel properlygather and <br />evaluate th formation submitted. Based on my inquiry of the person or persons who anage the <br />system, or those o persons directly belief, for enn the information, the a that h submitted is, <br />to W and ete am aware that there are ailcant <br />e best of m knowledge and behef, tine, e, accurate, and tete I am compp gn <br />penalties for submitting false information, including the posnbihty of f e and impnwnmrnt for knowing <br />violations. y <br />t <br />TELEPHONE <br />DATE <br />�`-� / qA^ <br />1) l a'✓f l n �,/ <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Cede NUMBER <br />MM /DD/YYYY <br />TYPED OR PRINTED <br />PERMITTEE NAME/ADDRESS (Include Facilty Name/Location if Different) <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 />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />C00044776 <br />PERMIT NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />69/0AI20Ot <br />MM /DDIYYYY <br />°99/30/2699 <br />FROM <br />-) - <br />001A <br />DISCHARGE NUMBER <br />TO <br />Form Approved <br />OMB No. 2040-0004 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />SR/MINE WTR TO DEER TRAIL DTCH <br />External Outfall <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, PG 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 />