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PARAMETER <br />1 certify under penalty of law that this document and all attachments were prepared under my &rut. or <br />super ,non in accordance with a system designed to assure that qualified personnel properly gather and <br />evaluate the information submitted Based on my mgmry of the person or persons who manage the <br />system, or those persons d responsible far gathering the complete the information submitted a, <br />m the best those se knowledge ge and and belief, truc for accurate and complete mpkm 1 am ,were that there are submitted <br />� la none orsobmittmg falsemformanon,, ncludingthepossibebty o ftmeandimpnsonmentforknowmg <br />�r <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />cib <br />z <br />z <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 />SAMPLE <br />MEASUREMENT <br />felt..... <br />PERMIT <br />Reqq. Mon. <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 my &rut. or <br />super ,non in accordance with a system designed to assure that qualified personnel properly gather and <br />evaluate the information submitted Based on my mgmry of the person or persons who manage the <br />system, or those persons d responsible far gathering the complete the information submitted a, <br />m the best those se knowledge ge and and belief, truc for accurate and complete mpkm 1 am ,were that there are submitted <br />� la none orsobmittmg falsemformanon,, ncludingthepossibebty o ftmeandimpnsonmentforknowmg <br />�r <br />�/ l ' <br />TELEPHONE <br />DATE <br />. <br />Oaf OPC) ll <br />/0 - g . t5) <br />(�' / • ./ ^ . <br />o ,.� _ i/ /3 <br />(/ / l / <br />SIGN ATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code I NUMBER <br />MM /DD/YYYY <br />OR NT <br />TYPED OR PRINTED <br />PERMITTEE NAME /ADDRESS (Include FacilityName/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 HVVY 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 />C00044776 <br />PERMIT NUMBER <br />009A <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />09fe1fz9A9 <br />MM /DD/YYYY <br />69/S6t20D9-- <br />o /pi 1l <br />TO <br />Form Approved <br />OMB No. 2040 -0004 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />SR DSCH /UNNMD TRIB /HUBBARD CRK <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 RPTD MEASUREMENTS -SEE I.A.3,PG. 4 -5 FOR BURDEN OF <br />PROOFREQUIREMENTS. OIL & GREASE - I.B.1.3, PG. 9. QRTRLY SAMPLING INSTRUCTIONS - I.C.10, PG. 10. <br />Page 2 <br />