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NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different) <br />NAME: Terror Creek LLC <br />QUANTITY OR LOADING <br />ADDRESS: 43440 Bowie Rd <br />NO. <br />EX <br />Paonia, CO 81428 <br />SAMPLE <br />TYPE <br />FACILITY: TERROR CREEK LOADOUT <br />VALUE <br />LOCATION: 43440 BOWIE ROAD <br />VALUE <br />PAONIA, CO 81428 <br />►M � ke L,,\4At.v <br />ATTN: 6 <br />?T&5,'C'L"� <br />COG850028 I 002 -A <br />PERMIT NUMBER I I DISCHARGE NUMBER <br />MONITORING PERIOD <br />MWDD/YYYY MWDDMlYY <br />10/0112014 12/31/2014 <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 />ice" under penalty of law that this document and all attachments were prepared under my direction or <br />aupervlewn in accordance a system designed to assure that personnel property gather and <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 />840661 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />p1 <br />i r <br />to the beat of my knowledge and belief, true, accurate, and complete I am aware that there are <br />significant penalties for submitting false information, Including the possibility of fine and knprisonment for <br />vowing violations. <br />0 2d/ <br />SIGNATURE &F PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />TYPED OR PRINTED <br />AREACode <br />NUMBER <br />1AM&NM <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />PERMIT <br />REQUIREMENT <br />*`*«" <br />Req. Mon. <br />INST MAX <br />Y =1;N =0 <br />« «.*.* <br />.. «" <br />»M« <br />« * "" <br />Twice Per <br />Month <br />VISUAL <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />ice" under penalty of law that this document and all attachments were prepared under my direction or <br />aupervlewn in accordance a system designed to assure that personnel property gather and <br />TELEPHONE <br />DATE <br />the peroon or persona wM manage the <br />bmi on my i person or <br />alum, the Information eubmiked Based on Inquiry <br />,o to 0 Gt j <br />or <br />system, or tlrose pereorx directly responsible for gathering the Information. the Inormat. aubmitied . <br />g <br />r <br />p1 <br />i r <br />to the beat of my knowledge and belief, true, accurate, and complete I am aware that there are <br />significant penalties for submitting false information, Including the possibility of fine and knprisonment for <br />vowing violations. <br />0 2d/ <br />SIGNATURE &F PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />TYPED OR PRINTED <br />AREACode <br />NUMBER <br />1AM&NM <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 <br />INPART I.B.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 />04/1012014 <br />Page 2 <br />