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PERMITTEE NAME /ADDRESS (Include Facility Name/Location d Different) <br />NAME: Oxbow Mining LLC <br />ADDRESS: PO Box 535 <br />Somerset, CO 81434 <br />FACILITY: ELK CREEK MINE <br />LOCATION: 3737 HWY 133 <br />SOMERSET, CO 81434 <br />ATTN- Mike Ludlow, Exec VP <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />COG850064 015 -B DMR Mailing ZIP CODE <br />PERMIT NUMBER DISCHARGE NUMBER MINOR <br />MONITORING PERIOD Discharge to Elk Creek <br />MM/DD/YYYY MM/DD/YYYY External Outfali <br />04/16/2013 06/30/2013 <br />Form Approved <br />OMB No. 2040 -0004 <br />81434 <br />No Discharge = <br />PARAMETER <br />I certify under penalty of law that this document and all attachments were prepared under my direction or <br />supery —n in accordance with a system designed to assure that qualified personnel property gather and <br />.lost the information submitted Based an my mgwry of the pennon or persons who manage the <br />system, or those persons directly responsible for gathering the information the information submitted is, <br />to the best of my knowledge and belief true accurate, and complete 1 am aware that mere are <br />sgnmcant penalties for submitting false information, including the possibilay of fine and imprisonment for <br />"owmg— I.Wris <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 />840661 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />" ".. <br />U <br />1 <br />L <br />_ '.' <br />= t • , <br />PERMIT <br />REQUIREMENT <br />« " "« <br />Req. Mon. <br />INST MAX <br />Y =1,N =0 <br />" "" <br />" « «" <br />" "" <br />" "" <br />Twice Per <br />Month <br />VISUAL <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />I certify under penalty of law that this document and all attachments were prepared under my direction or <br />supery —n in accordance with a system designed to assure that qualified personnel property gather and <br />.lost the information submitted Based an my mgwry of the pennon or persons who manage the <br />system, or those persons directly responsible for gathering the information the information submitted is, <br />to the best of my knowledge and belief true accurate, and complete 1 am aware that mere are <br />sgnmcant penalties for submitting false information, including the possibilay of fine and imprisonment for <br />"owmg— I.Wris <br />r <br />1 <br />" y i'r� -'I i.-f i '-✓\ <br />TELEPHONE <br />DATE <br />' Vr' 5 <br />TYPED OR PRINTED <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />ngFA <br />NUMBER <br />MMID lMYYY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />Settleable solids limit waived for 10 -yr, 24 hr precip event subject to burden of proof requirements in Part 1.B.6. Any additional data shall be supplied to the division within 48 hours. <br />EPA Form 3320 -1 (Rev.01 /06) Previous editions may be used. <br />05/30/2013 <br />Page 1 <br />