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PERMITTEE NAME/ADDRESS !include Facility Name/Location if <br />Ugl Oxbow dining LLC <br />ADDRESS: PO Box 535 <br />Somerset, CO 81434- 0535 <br />FACILITY: SANBORN CRI: & ELK CRI; TUNES <br />LOCATION: 3737 HIGHWAY 133 <br />SOMERSET. CO 81434 <br />ATTN: ~like Ludlow, 11'res <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />C0000013'2 <br />009- A <br />PERMIT NUMBER <br />I DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM/DD/YYYY <br />VALUE <br />MM/DD/YYYY <br />12/01/2015 <br />VALUE <br />12/31/2015 <br />Form Approved <br />OMB No. 2040- 0004 <br />DMR Mailing ZIP CODE: 81424- 0535 <br />MINOR <br />GUNIS <br />SURF RUNOFF TO N FK GUNIS RIVR <br />External Outfall <br />No Discharge <br />PARAMETER <br />I camty under pe Ity of taw that thts drKutnent end a0 auachrnents t— pmpamd under mt <br />QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br />FREQUENCY <br />OF ANALYSIS <br />SAMPLE <br />TYPE <br />VALUE <br />VALUE <br />UNITS VALUE <br />VALUE <br />VALUE <br />UNITS EX <br />Oil and grease visual <br />840661 0 <br />Effluent Gross <br />SAMPLE <br />MEASUREMENT <br />SIGNA OF PRINCIPAL CUTTVE OFFICER OR <br />I <br />„rare and .,rn.pterr. i ama are ma tnrrrarr umtK:mt p .,h,r tnin"bmurtna mi.r <br />�, %D -24.6634 <br />Gl f Ob1�01� <br />nt,K„,...... , Wdmµ mr pns+tbdrry ul h u amt mrpr, r„mint trK t nn..md.;ntatwn.. <br />AUTHORIZID AGENT <br />PERMIT <br />REQUIREMENT <br />****** <br />Req. Mon. <br />INST MAX <br />N= O;Y= ] "*""** <br />"°"*^^ <br />****** <br />"*"^** <br />Monthly <br />VISUAL <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />I camty under pe Ity of taw that thts drKutnent end a0 auachrnents t— pmpamd under mt <br />TELEPHONE <br />DATE <br />direction or suprnision in accordance pith a system d"jgned to assurr that quahhed <br />•rv>nnel properly gather and araluam the mfnrmannn submined. Road nn my ..gtdrt nt ,hr <br />I.- t nr par+onr who marline rhr +r stem, ar those par*tma drrerty rr+pnmtblc for pathannK <br />the mtormanon, the information subtmned is, to the best of my lnimied a and belief, true. <br />! r <br />L <br />SIGNA OF PRINCIPAL CUTTVE OFFICER OR <br />I <br />„rare and .,rn.pterr. i ama are ma tnrrrarr umtK:mt p .,h,r tnin"bmurtna mi.r <br />�, %D -24.6634 <br />Gl f Ob1�01� <br />nt,K„,...... , Wdmµ mr pns+tbdrry ul h u amt mrpr, r„mint trK t nn..md.;ntatwn.. <br />AUTHORIZID AGENT <br />TYPID OR PRINTED <br />,� coa< NUMBER <br />Mroo/YVYY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />TSS & TOTAL IRON LIMITS IkILL BE WAIVED, AND SETTLEABLE SOLIDS LMT APPLIED FOR <- IOYR,24HR PRECIP EVENT;SETTLEABLE SOLIDS 1JN11T MAY BE WAIVED FOR > I0YR,24HR EVENT - <br />SEE I.A.I,PP 4- 5, AND I.A.2, P. 5 FOR RQMNTS.TDS MONITORING- SEE PART VI.A.2.G OF RATIONALE 30 DAY AVG. IF HIGHEST MONTHLY AVG. DURING PERIOD REPRTD. <br />EPA Form 3320- 1 (Rev.01/06) Previous editions may be used. 01/05/2016 Page 1 <br />