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PERMITTEE NAME/ADDRESS (include Facility Name/Location if 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 001-A <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM/DD/YYYY MM/DD/YYYY <br />04/01/2015 06/30/2015 <br />Form Approved <br />OMB No. 2040-0004 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />DELTA <br />SEDT POND #1 TO N FORK GUNNISN <br />External Outfall <br />No Discharge <br />PARAMETER <br />I certify under penalty of law that this document and an attachments were prepared under my direction or <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 />****** <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />****** <br />****** <br />****** <br />****** <br />TYPED OR PRINTED <br />AREA Code NUMBER <br />MMIDD/YYVY <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 />I certify under penalty of law that this document and an attachments were prepared under my direction or <br />'t� 1 <br />TELEPHONE <br />DATE <br />supew slon in accordance with a system designed to assure that qualified personnel properly gather and <br />valuate the information submitted Based on my inquiry of the person or persons who manage the <br />system, or those persons directly responsible for gathering the information, the information submitted is, <br />,' : t t <br />t <br />to the best of my knowledge and belief, true, accurate, and complete I am aware that there are significant <br />�� _HZy L <br />SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />r C'5li <br />penalties for submitting false information, including the possibility of fine and imprisonment for knowing <br />violations <br />1 <br />TYPED OR PRINTED <br />AREA Code NUMBER <br />MMIDD/YYVY <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 <br />DIVISION WITHIN 48 HOURS. <br />EPA Form 3320-1 (Rev.01106) Previous editions may be used. 07/21/2014 Page 78 <br />