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PERMITTEE NAME /ADDRESS (Include Facility NamelLocatfon fl Different) <br />NAME: Terror Creek LLC <br />ADDRESS: 43440 Bowie Rd <br />Paonia, CO 81428 <br />FACILITY: TERROR CREEK LOADOUT <br />LOCATION: 43440 BOWIE ROAD <br />PAONIA, CO 81428 <br />ATTN. JAMES T. COOPER, PRESIDENT <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />COG850028 002 -A <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY MM /DD/YYYY <br />07/01/2013 09/30/2013 <br />Form Approved <br />OMB No 2040 -0004 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />DELTA <br />DUGOUT POND TO N FORK GUNNISON <br />External Outfall <br />No Discharge <br />PARAMETER <br />IceM yun derpenattyoflawthatthadocument andall attachmentswerepreparedundermybrecbonor <br />- ns <br />pervm m accordance with a system designed to assure that Qualified personnel property gather and <br />.fuel. the information submitted Based on my mquuy of the person or persons who manage the <br />system, or those persons directly responsible for gathering the information, the information submitted s, <br />to the best of my knowledge and befief bue, accurate, and complete I am aware that there are <br />srgnificanl penalties for submdbng false mformation including the posebddyofAm and imprisonment fw: <br />ow,ngwdations <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 />Oil and grease visual <br />8406610 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />'••••• <br />Page 2 <br />••• * ** <br />• *•' *' <br />• *• "• <br />•••'•• <br />PERMIT <br />REQUIREMENT <br />" "'" <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />" "" <br />" "`" <br />" *` ** <br />" " "" <br />Twice Per <br />Month <br />VISUAL <br />NAME /TITLE PRINCIPAL EXECUTIVE OFFICER <br />IceM yun derpenattyoflawthatthadocument andall attachmentswerepreparedundermybrecbonor <br />- ns <br />pervm m accordance with a system designed to assure that Qualified personnel property gather and <br />.fuel. the information submitted Based on my mquuy of the person or persons who manage the <br />system, or those persons directly responsible for gathering the information, the information submitted s, <br />to the best of my knowledge and befief bue, accurate, and complete I am aware that there are <br />srgnificanl penalties for submdbng false mformation including the posebddyofAm and imprisonment fw: <br />ow,ngwdations <br />/ <br />Y' - ' `� ! k �� <br />TELEPHONE <br />DATE <br />�tU�/• V�f�G�tnu <br />��L 7y� —s� L 0 <br />(0 C) 2- <br />I <br />IGNATUREOF PRINCIPAL EXECUTIVE OFFICEROR <br />AUTHORIZED AGENT <br />TYPED OR MINTED <br />aaeaeoae <br />NUMBER <br />M D <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SETTLEABLE SOLIDS LIMIT WAIVED FOR10 -YR, 24 HR PRECIP EVENT SUBJECT TO BURDEN OF PROOF REQUIREMENTS INPART 1.6 6. ANY ADDITIONAL DATA SHALL BE SUPPLIED TO THE <br />DIVISION WITHIN 48 HOURS. <br />EPA Form 3320 -1 (Rev.01/06) Previous editions may be used. <br />09/20/2013 <br />Page 2 <br />