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NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM(NPDES) Form Approved <br /> DISCHARGE MONITORING REPORT(DMR) OMB No.2040-0004 <br /> PERMITTEE NAME/ADDRESS(Include Facility Name/Location if <br /> NAME: Leone Sand and Gravel LLC COG502037 001A-9 MIN Mailing ZIP CODE: 81082 <br /> MINOR <br /> ADDRESS: 2400 E Main St PERMIT NUMBER DL4 CHARGE NUMBER <br /> Trinidad,CO 81082 <br /> MONITORING PERIOD Discharge to Huerfano River <br /> FACILITY: LEONE HUERFANO GRAVEL PIT MM/DD/YYYY MM/DD/YYYY External Outfall <br /> LOCATION:3251 CR 611 10/01/2021 12/31/2021 No Discharge <br /> WALSENBURG, CO 81089 <br /> ATTN:Frank Leone Jr, Mgr <br /> QUANTTTY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br /> PARAMETER VALUE VALUE UNITS VALUE VALUE VALUE UNITS EX OF ANALYSIS TypE <br /> Selenium,potentially dissolvd SAMPLE ****** ****** ****** ****** ****** <br /> MEASUREMENT <br /> 01323 10 PERMIT ****** ****** ****** ****** Req.Mon. ****** ug/L Quarterly GRAB <br /> Effluent Gross REQUIREMENT QRTR AVG <br /> PNi' <br /> �0. <br /> NAME/-I=PRINCIPAL EXECUTIVE OFFICER i certify under penalty of law that this document and all attachments were prepared under my TELEPHONE DATE <br /> direction or supervision in accordance with a system designed to assure that qualified <br /> sonnet properly gather and evaluate the information submitted.Based on my inquiry of the �7 <br /> person or persons who manage the system,or those persons directly responsible for gathering <br /> r j the udormnd c the information I a a submitted he is,to the best of penalties <br /> knowledge and be sting Live, /7Q <br /> IH accurate,and complete.I am aware that there are significant penalues for submitting false SIGNATURE OF PRINCIPAL EXE CER OR <br /> information,including the possibility of fine and imprisonment for knowing violations. AUTHORIZED AG <br /> AREA Code NUMBl1t /DD/YYY Y <br /> TYPED OR PRINTED <br /> COMMENTS AND EXPLANATION OF ANY VIOLATIONS(Reference all attachments here) <br /> EPA Form 3320-1(Rev.01/06)Previous editions may be used. 12/20/2017 Page 1 <br />