PARAMETER
<br />1 certify undo prnal,y aw ,ha, ,hu doct a all aeac=s prepard under d,rcnm w
<br />Di rt „„ n � nwo�f l , W „h,.yam umen m ,, d ,.a�e m.,y .,rd my r„he ad
<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 />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 />N ME/TITLE PRINf)IPAL ECUTNE OFFICER
<br />1 certify undo prnal,y aw ,ha, ,hu doct a all aeac=s prepard under d,rcnm w
<br />Di rt „„ n � nwo�f l , W „h,.yam umen m ,, d ,.a�e m.,y .,rd my r„he ad
<br />/, (
<br />7
<br />TELEPHONE
<br />DATE
<br />in,
<br />�NV �awc.
<br />I ■ t w bin tied , h Based on my inquiry of the r,a...,
<br />or a who manage .,uge,he
<br />at thready
<br />ra responsible accurate., turc rn submitted t o the b
<br />m,he ca of of m my knowledge and d belief, accu,, and a eompkte I am aware c arc vfi
<br />gn,un,
<br />renalnea f submitting ,ba d r
<br />n ,tyofrnca,mpr„onman knowing
<br />9 �/J/r [ /
<br />Q / / i J �r�
<br />(,/ 3
<br />0 / Q�l�� I
<br />SIGN RE OF PRINCIPAL EX U
<br />AUTHORIZED AGENT
<br />SS��
<br />TYPED OR PRIMA
<br />la
<br />AREA Code NUMBER
<br />,4/2 //{
<br />M D/YYYY
<br />PERMITTEE NAME /ADDRESS (hick/de 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.01106) 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 />01/01/2013
<br />MM /DD/YYYY
<br />03/31/2013
<br />TO
<br />DMR Mailing ZIP CODE: 81428
<br />MINOR
<br />DELTA
<br />SEDI POND #1 TO N FORK GUNNISN
<br />External 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.
<br />Page 2
<br />
|