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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 DMR Mailing ZIP CODE: 81001 <br /> NAME: Beltramo, Tony J&Sons Inc COR900355 001Q-D1 MINOR <br /> ADDRESS: 1541 Stockyard Rd PERMIT NUMBER DISCHARGE NUMBER <br /> Pueblo, CO 81001 MONITORING PERIOD Benchmark Monitoring- Subsector Dl <br /> FACILITY: ASPHALT BATCH PLANT MM/DD/YYYY MM/DD/YYYY External Outfall <br /> LOCATION:1541 STOCKYARD RD 10/01/2021 12/31/2021 No Discharge <br /> PUEBLO, CO 81001 <br /> ATTN:Timothy Beltramo, SecTreasurer <br /> QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br /> PARAMETER VALUE VALUE UNITS VALUE VALUE VALUE UNITS EX OF ANALYSIS TYPE <br /> Solids,total suspended SAMPLE No **i°*** O NO No <br /> MEASUREMENT Discharge Discharge Discharge Discharge <br /> 0053010 PERMIT ****** ****** ****** ****** 100 ****** mg/L Quarterly GRAB <br /> Effluent Gross REQUIREMENT QRTR AVG <br /> NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I certifi under penalty of law that this document and all attachments were prepared under my '� � TELEPHONE DATE <br /> direction or supers tston to accordance with a system designed to assure that qualttied <br /> et sonncl properly gather and e,aluate the information submitted Based on my ingmry of the <br /> person or persons who manage the system,or those persons directly responsible for gathering <br /> Tim Beltramo—V Pres the information,the information submitted is,to the best of my knowledge and belief,true, 7 (1—CAA A7A A <br /> accurate,and complete.I am aware that there are significant penalties for submitting false SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR a7 J�"F�Y'Y t Y�'1' C.a� <br /> information,including the posstbtldy of tine and imprisonment for knowing,inlations AUTHORIZED AGENT <br /> TYPED OR PRINTED AREA Code NUMBIIt /DD/YYYY <br /> COMMENTS AND EXPLANATION OF ANY VIOLATIONS(Reference all attachments here) <br /> Benchmark monitoring- see I.2.,pp 27-28 <br /> EPA Form 3320-1(Rev.01/06)Previous editions may be used 12/28/2017 Page 1 <br />