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PARAMETER
<br />1 certify under penalty of law that this document and all attachment „ere prepared under my direction or
<br />. upervnnnnnac, nrdam, wuhaa y, temdem gncdwa., urcth. aqualif edp,ntumelprperlycathermd
<br />• lu t d • ml nn t n tit nun d Ua d ■ i my inqu,n od the p,mon or p.r.rnu who manage doe
<br />ten �r of i Anowl g . , an h&c! tru, h a n d du. mmnnan,on the . I h Ji then summ�nd„
<br />m the n.a, nl inv Annwi,Jg. and hel„1 w, auurat, and „nnpl,t, 1 am ,wart that thrn art atgnniwnt
<br />penal., penal., l .nbmiamg rape,nr m,anon mJmling me pn.,iwwv nrrne and impna^nm nt r « one„ ^
<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 />84066 1 0
<br />Effluent Gross
<br />SAMPLE
<br />MEASUREMENT
<br />NUMBER
<br />M M /DD
<br />Y
<br />TYPED OR.PRINTED
<br />PERMIT
<br />REQUIREMENT
<br />,... —.
<br />Req. Mon.
<br />INST MAX
<br />Y =1;N =0
<br />*** **'
<br />* * * * **
<br />Twice Per
<br />Month
<br />VISUAL
<br />NAME /TITLE PRINCIPAL�
<br />1 certify under penalty of law that this document and all attachment „ere prepared under my direction or
<br />. upervnnnnnac, nrdam, wuhaa y, temdem gncdwa., urcth. aqualif edp,ntumelprperlycathermd
<br />• lu t d • ml nn t n tit nun d Ua d ■ i my inqu,n od the p,mon or p.r.rnu who manage doe
<br />ten �r of i Anowl g . , an h&c! tru, h a n d du. mmnnan,on the . I h Ji then summ�nd„
<br />m the n.a, nl inv Annwi,Jg. and hel„1 w, auurat, and „nnpl,t, 1 am ,wart that thrn art atgnniwnt
<br />penal., penal., l .nbmiamg rape,nr m,anon mJmling me pn.,iwwv nrrne and impna^nm nt r « one„ ^
<br />ti / - _ w I
<br />LVY �/�
<br />TELEPHONE
<br />DATE
<br />C,•IM.e.q
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<br />C ( ` T
<br />• Y\ l.Y C t �
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<br />SI NATURE OF PRINCIP
<br />AUTHOR I
<br />EXECUTIVE OFFICER OR
<br />D AGENT
<br />AREA Code I
<br />NUMBER
<br />M M /DD
<br />Y
<br />TYPED OR.PRINTED
<br />PERMITTEE NAME /ADDRESS (/nc /ude 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 />EPA Form 3320 -1 (Rev.01 /06) Previous editions may be used.
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
<br />DISCHARGE MONITORING REPORT (DMR)
<br />FROM
<br />COG850028
<br />PERMIT NUMBER
<br />001A
<br />DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />MM /DD/YYYY
<br />10/01/2011
<br />MM /DD/YYYY
<br />12/31/2011
<br />TO
<br />DMR Mailing ZIP CODE: 81428
<br />MINOR
<br />DELTA
<br />SEDI POND #1 TO N FORK GUNNISN
<br />Extemal Outfall
<br />Form Approved
<br />OMB No 2040 -0004
<br />No Discharge(
<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 DIVISION WITHIN 48 HOURS.
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