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PERMITTEE NAME /ADDRESS (/ nc/ udeFaci /ityName/LocationlfDifferel7o <br />NAME: <br />Bowie Resources LLC <br />ADDRESS: <br />PO Box 483 <br />NO. <br />EX <br />Paonia, CO 81428 <br />FACILITY: <br />BOWIE NO. 2 MINE <br />LOCATION: <br />5 MI NE OF TOWN ON CO HWY 133 <br />VALUE <br />PAONIA, CO 81428 <br />ATTN: BRADLEY E. HANSON, VICE PRES <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />C00044776 002A <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY MM /DD/YYYY <br />FROM 094142909 TO _09404QG9— <br />Form Approved <br />OMB No. 2040 -0004 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />SR;DEER TRL DTC OR UNMD TRIB <br />External Outfall <br />No Discharge <br />PARAMETER <br />Ieemfyunderpenalty• oflaw that this daumcnt and all anachmcntswereprcpared undo,mydtmcttonor <br />supers atan in aceerdan e w tth a system de :rgned w a :sem mat gnahred personnel pmpedy ga er and <br />evaluate the mfotmaaon submmed Based on my mgmry of the person or persons who manage the <br />system, or those persons drre,,ily msponsble for gathering the mto—Inni, the udbrmatmn submmed is, <br />best knowledge belief, <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 />SIGNATUREOF PRINCIPAL EXECUTIVE OFFICER OR' <br />TYPED OR PRINTED <br />Oiland grease visual <br />SAMPLE <br />...... <br />NUMBER <br />MM /DD/YYYY <br />...... <br />...... <br />...... <br />MEASUREMENT <br />840661 0 <br />Effluent Gross <br />PERMIT <br />REQUIREMENT <br />...... <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />"` " <br />"• "` <br />" "" <br />Weekly <br />VISUAL <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />Ieemfyunderpenalty• oflaw that this daumcnt and all anachmcntswereprcpared undo,mydtmcttonor <br />supers atan in aceerdan e w tth a system de :rgned w a :sem mat gnahred personnel pmpedy ga er and <br />evaluate the mfotmaaon submmed Based on my mgmry of the person or persons who manage the <br />system, or those persons drre,,ily msponsble for gathering the mto—Inni, the udbrmatmn submmed is, <br />best knowledge belief, <br />' <br />, <br />TELEPHONE <br />DATE <br />_� <br />/„ / <br />dI a� <br />C � <br />to the of my and true, r—te and complete. l am aware that then arc stgntfi, ant <br />es <br />pcforsubmnnngfalsemf ormanoo, mcludmgthepossibthtyo ffineandtmpnsonmcntforknowmg <br />violations <br />f } <br />/Tl <br />"` <br />SIGNATUREOF PRINCIPAL EXECUTIVE OFFICER OR' <br />TYPED OR PRINTED <br />AUTHORIZED AGENT <br />AREA Code <br />NUMBER <br />MM /DD/YYYY <br />- -, YtVU.1 w- trc.telelllw dll allacntnenlw nerel <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 />EPA Form 3320.1 (Rev.01 /06) Previous editions may be used. Page 2 <br />