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PERMITTEE NAME/ADDRESS ( tnctudeFacitdyName /LocationifDilferent) <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 001A <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY MM /DD/YYYY <br />FROM - e9Mtf2e09 TO A960721_9F <br />071 M i 13,& (3 c��l 11 f3 <br />Form Approved <br />OMB No. 2040-0004 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />(SUBR MH) DELTA <br />SR/MINE WTR TO DEER TRAIL DTCH <br />External Outfall <br />No Discharge <br />PARAMETER <br />�mryunderpenalyoflawt hat thsdocument, ndall attaehmentswerepreparedundermydocam nor <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 />to ,he list of my knowledge and b:hcf, tine, accurate and complem f am aware that there are significant <br />Penalties for submitting false information, including the possibility of fine and imprisonment for knowing <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code <br />NUMBER <br />MM /DD/YYYY <br />Oiland grease visual <br />SAMPLE <br />MEASUREMENT <br />...... <br />,cy <br />IJ <br />....., <br />...... <br />...,,. <br />....., <br />% <br />84066 1 0 <br />Effluent Gross <br />PERMIT <br />REQUIREMENT <br />..... , <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />...... <br />...... <br />...... <br />... ... <br />Weekly <br />VISUAL <br />NAMERITLE PRINCIPAL EXECUTIVE OFFICER <br />�mryunderpenalyoflawt hat thsdocument, ndall attaehmentswerepreparedundermydocam nor <br />TELEPHONE <br />DATE <br />su pentvonmaccorJanceevthasystemdesgneJtoassum that quahficdpesonnel property gather and <br />valuate the information submitted Based on my inquiry oCthe person or persons who manage the <br />system, or thou persons directly responsible for gathenng the information, the information submitted is, <br />JJJ��� <br />1 , <br />/ <br />p \ �` a <br />` J /' '� <br />to ,he list of my knowledge and b:hcf, tine, accurate and complem f am aware that there are significant <br />Penalties for submitting false information, including the possibility of fine and imprisonment for knowing <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code <br />NUMBER <br />MM /DD/YYYY <br />U. C <br />violation. <br />IJTYPED OR PRINTED <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SETTLEABLE SOLIDS LIMIT APPLIES ONLY IF <IOYR,24HR PRECIP EVENT IS CLAIMED, IF CLAIM APPROVED BY WQCD,TSS & IRON LIMITS WILL NOT BE APPLIED TO REPORTED MEASUREMENTS -SEE I.A.3, PG 4 -5 FOR <br />BURDEN OF PROOFREQUIREMENTS. OIL & GREASE - 1.8.1,3, PG 9. QRTRLY SAMPLING INSTRUCTIONS- I.C.10, PG. 10. <br />EPA Form 3320 -1 (Rev.01 106) Previous editions may be used. Page 2 <br />