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PERMITTEE NAME /ADDRESS (Include FacilityName/Location dDffferent) <br />NAME: Moffat County Mining LLC <br />ADDRESS: 29515 Routt CR 27 <br />Oak Creek, CO 80467 -9704 <br />FACILITY- WILLIAMS FORK MINE <br />LOCATION. 1030 CR 107 <br />CRAIG, CO 81626 <br />ATTN' Jerry Nettleton, Supv <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />C00034142 024 -X <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY MM /DD/YYYY <br />11.(1/2842 12434/2bfT' <br />DMR Mailing ZIP CODE <br />MINOR <br />Chronic WET Testing at 024A <br />External Outfall <br />Form Approved <br />OMB No 2040 -0004 <br />80467 -9704 <br />No Discharge �K <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of law that this document and all attachments were prepared under my direction or n TELEPHONE DATE <br />supervision m 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 r, <br />to the best of my knowledge and belief true accurate and complete I am aware that there are --' 2 6 l <br />VVV 1 C 7 V sq,r cant penalties for submitting false mfermanen mcludmg the po—Why y of fine and imprisonment m, SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR O 7� �- �V ()% <br />TYPED OR PRINTED owing violations AUTHORIZED AGENT gREA Cotle <br />NUMBER MMIDD/YVVY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SEE I B.3, FOT DETAILS OF TEST PROCEDURE. RPT RESULTS OF LETHALITY DERIVS AS "% EFFECT ", GROWTH &REPRODDERIVS AS "TOXICITY" RPT LOWEST % EFFL AT WHICH <br />STATISTICALLY SIGNIF 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 1 <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />FREQUENCY <br />SAMPLE <br />PARAMETER <br />EX <br />OF ANALYSIS <br />TYPE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNITS <br />Toxicity [chronic], Cerodaphnia dubia <br />SAMPLE <br />* * * * ** <br />* * * « ** <br />* * »« <br />«« « « <br />MEASUREMENT <br />61426 P 0 <br />PERMIT <br />` * " * "* <br />` ** <br />Req. Mon. <br />` * * ** <br />" * * * "* <br />tox chronic <br />Annual <br />GRAB -3 <br />See Comments <br />REQUIREMENT <br />MN VALUE <br />Toxicity [chronic], Cenodaphnia dubia <br />SAMPLE <br />* * * * ** <br />MEASUREMENT <br />61426 S 0 <br />PERMIT <br />* * * ** <br />Req. Mon. <br />* ** <br />* * * * "* <br />tox chronic <br />Annual <br />GRAB -3 <br />See Comments <br />REQUIREMENT <br />MN VALUE <br />Toxicity (chronic), Pimephales <br />SAMPLE <br />promelas (Fathead Minnow) <br />MEASUREMENT <br />61428 P 0 <br />PERMIT <br />* * * * ** <br />* * * * ** <br />« *" <br />Req. Mon <br />"' <br />' * *` ** <br />tox chronic <br />Annual <br />GRAB -3 <br />See Comments <br />REQUIREMENT <br />MN VALUE <br />Toxicity (chronic), Plmephales <br />SAMPLE <br />promelas (Fathead Minnow) <br />MEASUREMENT <br />61428 S 0 <br />PERMIT <br />* * * *'* <br />..... <br />Req. Mon. <br />* * * * *' <br />* * * * ** <br />tox chronic <br />Annual <br />GRAB -3 <br />See Comments <br />REQUIREMENT <br />MN VALUE <br />%Effect Static Renewal 7 Day Chronic <br />SAMPLE <br />Cenodaphnia dubia <br />MEASUREMENT <br />TCP36 P 0 <br />PERMIT <br />* * * * ** <br />" * * ** <br />' * " "` <br />Req. Mon. <br />* ** <br />* * * * *" <br />% <br />Annual <br />GRAB -3 <br />See Comments <br />REQUIREMENT <br />MN VALUE <br />%Effect Static Renewal 7 Day Chronic <br />SAMPLE <br />Cerodaphnia dubia <br />MEASUREMENT <br />TCP3B S 0 <br />PERMIT <br />* * * *'* <br />* * * * ** <br />*` *' *` <br />18 <br />* * * * ** <br />* * * * ** <br />p/ <br />Annual <br />GRAB -3 <br />See Comments <br />REQUIREMENT <br />MN VALUE <br />%Effect Statre 7Day Chronic <br />SAMPLE <br />* * ** <br />* * * * ** <br />* * * * ** <br />Plmephales <br />MEASUREMENT <br />TCP6C P 0 <br />PERMIT <br />* * * * ** <br />* * * * *' <br />* * * * ** <br />Req. Mon. <br />*' * * ** <br />* * * * ** <br />% <br />Annual <br />GRAB -3 <br />See Comments <br />REQUIREMENT <br />MN VALUE <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of law that this document and all attachments were prepared under my direction or n TELEPHONE DATE <br />supervision m 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 r, <br />to the best of my knowledge and belief true accurate and complete I am aware that there are --' 2 6 l <br />VVV 1 C 7 V sq,r cant penalties for submitting false mfermanen mcludmg the po—Why y of fine and imprisonment m, SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR O 7� �- �V ()% <br />TYPED OR PRINTED owing violations AUTHORIZED AGENT gREA Cotle <br />NUMBER MMIDD/YVVY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SEE I B.3, FOT DETAILS OF TEST PROCEDURE. RPT RESULTS OF LETHALITY DERIVS AS "% EFFECT ", GROWTH &REPRODDERIVS AS "TOXICITY" RPT LOWEST % EFFL AT WHICH <br />STATISTICALLY SIGNIF 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 1 <br />