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PERMITTEE NAME /ADDRESS (Include Facility Name /Location if Different) <br />NAME: <br />Moffat County Mining LLC <br />ADDRESS: <br />29515 Routt CR 27 <br />MONITORING PERIOD <br />Oak Creek, CO 80467 -9704 <br />FACILITY- <br />WILLIAMS FORK MINE <br />LOCATION. <br />1030 CR 107 <br />1.2i341:91z-' <br />CRAIG, CO 81626 <br />ATTN• Jerry Nettleton, Supv <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />000034142 <br />022 -X <br />PERMIT NUMBER <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY <br />SAMPLE <br />TYPE <br />MM /DD/YYYY <br />- i�129� <br />UNITS <br />1.2i341:91z-' <br />E �(12 o(3 <br />C /zc /'zsr <br />Form Approved <br />OMB No. 2040 -0004 <br />DMR Mailing ZIP CODE: 80467 -9704 <br />MINOR <br />Chronic WET Testing at 022A <br />External Outfall <br />No Discharge <br />/ <br />PARAMETER <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 />%Effect Statre 7Day Chronic <br />Plmephales <br />TCP6C S 0 <br />See Comments <br />SAMPLE <br />MEASUREMENT <br />* * * * ** <br />* * * * ** <br />* * * * ** <br />�--,/oG <br />* *• *•• <br />*• * * ** <br />/ <br />if <br />PERMIT <br />REQUIREMENT <br />^ ^ ^ ^ ^^ <br />^ * ** <br />18 <br />MN VALUE <br />* * ^ ** <br />% <br />Annual <br />GRAB -3 <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of law that this document and all attachments were prepared under my hreabo nor % TELEPHONE DATE <br />supernsion in accordance with a system designed to assure that qualified personnel properly gather and <br />valuate the information submitted Based on my inquiry of the person or persons who manage the <br />system or those persons directly responsible for gathering the information, the information submitted is <br />' N to the best of my knowledge and belief true, accurate and complete I am aware that them are <br />�`�f1 �' `C1 ✓�Qy/1 sig - n, 1pe nalbes forsubmpbngfalseinformationincludingthepo— bl,tyoffineandimpnsonmenlfor SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />TYPED OR PRINTED owing wolab.- AUTHORIZED AGENT nlxen, coos <br />NUMBER MMl...Il <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SEE I B.3, FOR DETAILS OF TEST PROCEDURE RPT RESULTS OF LETHALITY DERIVS AS "% EFFECT" GROWTH &REPRODDERIVS AS "TOXICITY" RPT LOWEST % EFFL AT WHICH <br />STATISTICALLY DIGNIF DIFF WAS OBSERVED USING CODE "S ".RPT IC25 USING CODE "P" IWC =18%. ATTACH TOX REPORT FORM TO DMR <br />EPA Form 3320 -1 (Rev.01 /06) Previous editions may be used. 05/08/2013 Page 2 <br />