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PARAMETER <br />I cemfy under penalty of law that tins document and all attachments were prepared under my threcnon or <br />supervtsmn In accordance with a system designed to assure that qualified personnel properly gather and <br />th f h Based <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 />4i — <br />r <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 />I cemfy under penalty of law that tins document and all attachments were prepared under my threcnon or <br />supervtsmn In accordance with a system designed to assure that qualified personnel properly gather and <br />th f h Based <br />TELEPHONE <br />DATE <br />e oat sub med. on my Inquiry of the person or persons who manage the <br />system, or those persons d responsible for gathering the in the information submitted m, <br />a <br />penalt es for ttmg false �nforrn on, t clud ni g possibility of r I am aware that there ule and m esonmen for knowing <br />violauons. <br />9 [-' '��+) <br />7��- �� ! -.7 f7'�J ( <br />�G� / �/)1 ^� <br />C _ (�C�1� �V`�[ 7 <br />iii // ei/ <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />TYPED OR PRINTED <br />AREA Code <br />I NUMBER <br />MM /DD/YYYY <br />PERMITTEE NAME/ADDRESS (include FacilityName/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 />FROM <br />ererence all attachments here <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 />002A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />b9f61/2699- <br />MM /DD/YYYY <br />a 3 <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 />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 />