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PERMITTEENAME/ADDRESS (I ncl udeFacddyNam&AocatronifDlferent) <br />NAME: <br />Terror Creek LLC <br />ADDRESS: <br />43440 Bowie Rd <br />NO. <br />�( <br />Paonia, CO 81428 <br />FACILITY: <br />TERROR CREEK LOADOUT <br />LOCATION: <br />43440 BOWIE ROAD <br />VALUE <br />PAONIA, CO 81428 <br />ATTN: JAMES <br />T. COOPER, PRESIDENT <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />COG850028 001 A <br />PERMIT NUMBER I DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM/DD/YYYY MM/DD/YYYY <br />FROM fE341941P949 TO I 81iiflW6�i3 <br />/2. <br />Form Approved <br />OMB No- 20400004 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />DELTA <br />SEDI POND #1 TO N FORK GUNNISN <br />External Outfall <br />No Discharge <br />PARAMETER <br />1—fy under penalty of law that this document and all attachments were prepared trader m drtecllon or <br />anpentaan,nauanau . wanaannmdeai ea aaanethat persume pnrperygamerana <br />ca aivate the those p—mn d—fly t It..w.t le m} the— of the person or pawns ao-n tannage the <br />system m those penom Juectly respomrbie fur gathermg the mfurmauon, the mfomutmn submated is, <br />to tht best kmtx Icdge belmf, Ism d— fican <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO. <br />�( <br />OF F A ANAALYSILYSI S <br />SAMPLE <br />TYPE <br />VALUE <br />VALUE <br />UNITS <br />VALUE <br />VALUE <br />VALUE <br />UNITS <br />peasihes , pm,,bibty <br />vmiattons <br />TYPED OR PRINTED <br />Oil and grease visual <br />SAMPLE <br />...... <br />...... <br />....,. <br />...... <br />...... <br />MEASUREMENT <br />840661 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 />Twice Per <br />Month <br />VISUAL <br />NAME(TITLE PRINCIP EXECUTIVE OFFICER <br />1—fy under penalty of law that this document and all attachments were prepared trader m drtecllon or <br />anpentaan,nauanau . wanaannmdeai ea aaanethat persume pnrperygamerana <br />ca aivate the those p—mn d—fly t It..w.t le m} the— of the person or pawns ao-n tannage the <br />system m those penom Juectly respomrbie fur gathermg the mfurmauon, the mfomutmn submated is, <br />to tht best kmtx Icdge belmf, Ism d— fican <br />- r <br />1n"'ril <br />- • a e <br />TELEPHONE <br />DATE <br />t <br />y /U ��y DSO � <br />ZD <br />rP d <br />of my end true, acetonic, and complete .ware that art n <br />for submntbng false mfomwtat mcludmg the of fin, and anp —a—t for knowm <br />IGNATURE OF PRIN PAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />ntiFa cone <br />NUMBER <br />DD/YYYY <br />peasihes , pm,,bibty <br />vmiattons <br />TYPED OR PRINTED <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SETTLEABLE SOLIDS LIMIT WAIVED FOR10 -YR, 24 HR PRECIPT EVENT SUBJECTTO BURDEN OF PROOF REQUIREMENTS INPART I.B.6. ANY ADDITIONAL DATA SHALL BE SUPPLIED TO THE DIVISION WITHIN 48 HOURS. <br />EPA Form 3320 -1 (Rev.01 /06) Previous editions may be used. Pape 2 <br />