The development of coal deposits is accompanied by negative environmental changes. In the territory of the Kizel coal basin (Perm Region, Russia), the problem of contamination of water sources by acid mine waters and runoff from rock dumps is particularly acute. Mine waters are acidic (pH 2–3), with high mineralization (up to 25 g/L) and significant content of sulfate ions, iron, aluminum, manganese, toxic trace elements (As, Co, Ni, Pb and Zn). They are formed as a result of the interaction of underground waters from flooded mines of the Kizel basin with coal and rocks of dumps with high sulfur content (15%). Uncontrolled inflow of mine water into rivers (about 22 million m3 annually) leads to significant amounts of iron and aluminum hydroxide precipitation. These precipitations are in active interaction with river water, polluting the rivers tens of kilometers downstream and are entering the Kama reservoir. Studies of alluvial precipitation can be considered as a method of control and predictors of technogenic water pollution. The mineral composition of river sediments was studied with the application of different methods, including studies of sand-gravel and silty-clayey sediments. The sandy-gravel grains in the bottom load are mainly composed by natural minerals and are represented by a significant number of particles of coal dumps, slags and magnetic spherules. The silty-clayey material, mixed with natural minerals, contains a significant number of amorphous phases with a predominance of iron-rich substances, which may actively concentrate toxic elements. The presence of jarosite, goethite, basaluminite, lepidorocite and copiapite in silty-clayey sediments are indicators of the influence of mine waters.