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PERMITTEE NAME /ADDRESS (includes Facility Name /Location If Different) <br />NAME <br />MOFFAT COUNTY MINING, LLC <br />ADDRESS <br />29515 ROUTT COUNTY ROAD # 27 <br />OAK CREEK, CO 80467 <br />FACILITY LOCATION <br />CRAIG CO <br />WILLIAMS FORK MINE <br />ATTN <br />JERRY N NETTLETON, C080467 <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) MINOR <br />DISCHARGE MONITORING REPORT (DMR) (SUER Jc) MOFFAT <br />Sr' ,(s Ne&Mlneto Williams Fork RV <br />Q Z2— External Oulfall <br />C00034142 -(>&-dh— = Check here If No Discharge <br />PERMIT NUMBER DISCHARGE NUMBER NOTE: Read Instructions before completing this form <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />01 01 TO 03 31 <br />S AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here, <br />INFLUENT SAMPLES MUST BE COLLECTED &ANALYZED MONTHLY AND REPORTED QUARTERLY REGARDLESS OF WHETHER AN EFFLUENT DISCHARGE OCCURS HYDRAULIC CAPACITY= 0015 MGD, <br />ORGANIC CAPACITY = 31 2 LBS BOD-5 /DAY <br />EPA Form 3320.1 (REV 3199) Previous editions may be used PAGE i OF 2 <br />00527/010709 -1126 <br />QUALITY OR LOADING <br />QUALITY OR CONCENTRATION <br />FREQUENCY <br />SAMPLE <br />PARAMETER <br />NO, <br />of <br />TYPE <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS <br />EX <br />ANALYSIS <br />ARSENIC, TOTAL <br />(AS AS) <br />SAMPLE " "`• "` <br />MEASUREMENT <br />" "'• <br />" "' " "" <br />/• S <br />c <br />/' J <br />(28) <br />Q <br />2/9 l <br />Grab <br />01002 1 0 0 <br />" " " " "' <br />REPORT <br />PERMIT <br />'•• " " <br />"' "" <br />""'" <br />REPORT <br />ONCE/ <br />EFFLUENT GROSS VALUE <br />REQUIREMEN <br />30DA AVG <br />DAILY MX <br />UG /L <br />PER MONTH <br />GRAB <br />ZINC, POTENTIALLY <br />SAMPLE I " "'•'" <br />'• "'•" <br />'•'••" <br />(28) <br />DISSOLVED <br />MEASUREMENT <br /><10 <br />< 10 <br />0 <br />219r <br />1 Grab <br />01303 1 0 0 <br />• "` °' <br />PERMIT <br />' "' "'" <br />' " " "" <br />' "' ^' <br />REPORT <br />REPORT <br />ONCE/ <br />EFFLUENT GROSS VALUE <br />REQUIREMENJ <br />I 300A AVG <br />DAILY AA <br />UGIL <br />PER MONTH <br />GRAB <br />SILVER, POTENTIALLY <br />SAMPLE " "" <br />• " ^ " "" <br />"` " "'" <br />(28) <br />DISSOLVED <br />MEASUREMEN T <br /><10 <br />< 10 <br />0 <br />219( <br />Grab <br />01304 1 0 0 <br />"• " " "" <br />PERMIT <br />'• °•• <br />' " " "" <br />' " °° <br />REPORT <br />REPORT <br />ONCE/ <br />EFFLUENT GROSS VALUE <br />REQUIREMEN <br />30DA AVG <br />DAILY Ma <br />UGIL <br />PER MONTH <br />GRAB <br />COPPER, POTENTIALLY <br />SAMPLE " " " " "" <br />"• " "" <br />•' " " "" <br />(28) <br />DISSOLVED <br />MEASUREMENT <br /><10 <br /><10 <br />0 <br />r <br />2(9(j <br />Grab <br />01306 1 0 0 <br />•`•••• <br />PERMIT <br />""" <br />'""" <br />' "•'•° <br />REPORT <br />REPORT <br />ONCE) <br />EFFLUENT GROSS VALUE <br />REQUIREMEN <br />30DA AVG <br />DAILY Mx <br />UGIL <br />PER MONTH <br />GRAB <br />CADMIUM <br />POTENTIALLY DISSOLVD <br />SAMPLE I "•••• " ", <br />MEASUREMENT <br />" "'"' " " "" <br />'•• "•• "•' <br />" tt • Z <br />' o,2- <br />-28 <br />0 <br />y <br />219Jy <br />Grab <br />01313 1 0 0 <br />" " " "" <br />PERMIT <br />"• " "' <br />'••'• "'" <br />" "` " "" <br />REPORT <br />REPORT <br />ONCER/ <br />EFFLUENT GROSS VALUE <br />REQUIREMENT <br />3D DA AVG <br />DAILY MX <br />UGIL <br />PER MONTH <br />GRAB <br />CHROMIUM TRIVALENT, <br />SAMPLE I ' "• "'" <br />"'•' ^` <br />" ^" ^' <br />(28) <br />POTENTIALLY DISSOLVD <br />MEASUREMENT <br /><10 <br />< 10 <br />0 <br />219 y <br />Grab <br />01314 1 0 0 <br />' " " " "" <br />PERMIT <br />' "`•" <br />'""" <br />'• "`•' <br />REPORT <br />REPORT <br />ONCE/ <br />EFFLUENT GROSS VALUE <br />REQUIREMENT <br />300A AVG <br />DAILY MX <br />UGIL <br />28) <br />0 <br />MONTH <br />219" <br />GRAB <br />Grab <br />LEAD, <br />POTENTIALLY DISSOLVD <br />SAMPLE •••••' <br />MEASUREMENT <br />" "' "' <br />" " " " "" <br />L , <br />( <br />e <br />01318 1 0 0 <br />" "' "" <br />PERMIT <br />• "• "' <br />" "" <br />" "" <br />REPORT <br />REPORT <br />ONCE/ <br />EFFLUENT GROSS VALUE <br />REQUIREMENT <br />30DA AVG <br />DAILY NIX <br />UG /L <br />MONTH <br />GRAB <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER <br />I Certify under penalty oflaw that this document and allanachments were prepared under <br />my direction or supervision In accordance with a system designed to assure that qualified <br />/ // _tea <br />r• l`) / i''�"�, i� <br />TELEPHONE <br />DATE <br />Brian A Watterson, P G <br />personnel properly gather and evaluate the Information submined Based on my Inquiry of <br />5 �c <br />970 870 - 275C <br />/ "9 <br />„x f� <br />- <br />Geologist <br />the person or persons who manage the system, or those persons directly responsible for <br />? <br />V / <br />SIGNATURE OF PRINCIPAL <br />AREA CODE NUMBER <br />YEA 11 <br />MO <br />I DAV <br />gathering the mformabon, the mfarmabon submided Is, to the best of my knowledge and belief <br />true, "urate, and complete I am aware that there are sigmficanl penalties for submdbng <br />false mfonnation, inclutlmg the possibility of fine and rmpnsonment for knowing vrolabons <br />OFFICER OR AUTHORIZED AGENT <br />TYPE OR PRINTED <br />i7 _ <br />1 10 / > <br />S AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here, <br />INFLUENT SAMPLES MUST BE COLLECTED &ANALYZED MONTHLY AND REPORTED QUARTERLY REGARDLESS OF WHETHER AN EFFLUENT DISCHARGE OCCURS HYDRAULIC CAPACITY= 0015 MGD, <br />ORGANIC CAPACITY = 31 2 LBS BOD-5 /DAY <br />EPA Form 3320.1 (REV 3199) Previous editions may be used PAGE i OF 2 <br />00527/010709 -1126 <br />