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PARAMETER <br />1 certify under penalty of law that tins document and all attachments were prepared under my dua:uon or <br />supervi <br />supervision in accordance with as stemdestgnedtoassurethatquahficdpersonnelproperlygatherand <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 />Cadmium, potentially dissolvd <br />01313 1 0 <br />Effluent Gross <br />SAMPLE MEASUREMENT <br />..,... <br />,,,,„ <br />,,,,,, <br />n �� <br />J <br />,, � <br />PERMIT <br />REQUIREMENT <br />" "" <br />Req. Mon. <br />3ODA AVG <br />Req. Mo . <br />DAILY MX <br />ug /L <br />Monthly <br />GRAB <br />Nickel, potentially dissolvd <br />01322 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />...... <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />30DA AVG <br />Req. Mon. <br />DAILY MX <br />ug /L <br />Monthly <br />GRAB <br />Selenium, potentially dissolvd <br />01323 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />...... <br />...... <br />...... <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />30DA AVG <br />Req. Mon. <br />DAILY MX <br />ug /L <br />Monthly <br />GRAB <br />Chromium, trivalent total recoverable <br />04262 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />...... <br />....,. <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />30DA AVG <br />Req. Mon. <br />DAILY MX <br />ug /L <br />Monthly <br />GRAB <br />M ercury, total (as Hg) <br />71900 1 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />...... <br />...... <br />...... <br />...... <br />PERMIT <br />REQUIREMENT <br />Req. Mon. <br />3ODA AVG <br />Req. Mon. <br />DAILY MX <br />ug /L <br />Monthly <br />GRAB <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />1 certify under penalty of law that tins document and all attachments were prepared under my dua:uon or <br />supervi <br />supervision in accordance with as stemdestgnedtoassurethatquahficdpersonnelproperlygatherand <br />A <br />//1- %r j � <br />,� , // / S ' ,l v �� <br />r <br />TELEPHONE <br />DATE <br />(�� P(,/ L e J <br />"" / / / / / / /// <br />l e , th f persons o sub tt •d Based lc or Inquiry of the person persons who manage the <br />or <br />system, or of those knowledge directly responvblc for gathering the information, Im the information the re sIg ttad rs, <br />to the best of m knowlcd a and M:bef, true, accumtc, and complete 1 am aware that there are sr ficant <br />penalties for submdt mg false information, mcludmg the possibility of fine and rmpnsonment for Ioowmg <br />vnola[rons <br />L � . <br />///��7 " "" <br />l <br />_ 5;1-5 <br />0- <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />/ TYPED OR PRINTED <br />4. <br />AREA Code <br />NUMBER <br />MMIDD/YYYY <br />PERMITTEE NAME/ADDRESS (Include Facility Name /Location "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 />TIONS (Reference 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 />FROM <br />03 /0/ /Nt 3 <br />MN10 <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />- 99f8112669-- <br />MM /DD/YYYY <br />-- r89h30f2669 <br />TO <br />03 /31 1300 <br />ONCE 12 MONTHLY SAMPLES HAVE BEEN COLLECTED THE PERMITTEE IS REQUIREDTO SUBMIT A REQUEST FOR AREASONABLE POTENTIAL ANALYSIS. <br />Form Approved <br />OMB No. 2040 -0004 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />MW TO UNNBD TRIB TO HUBBARD CR <br />External Outfall <br />No Discharge <br />Page 2 <br />