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PERM ITTEE NAM E /ADDRESS ( lncludeFacddyName /LocationifDiffereno <br />NAME: <br />Terror Creek LLC <br />ADDRESS: <br />43440 Bowie Rd <br />NO. <br />EX <br />Paonia, CO 81428 <br />FACILITY: <br />TERROR CREEK LOADOUT <br />LOCATION: <br />43440 BOWIE ROAD <br />VALUE <br />PAONIA, CO 81428 <br />ATTN: JAMES T. COOPER, PRESIDENT <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />COG850028 002A <br />PERMIT NUMBER I DISCHARGE NUMBER <br />MONITORING PERIOD <br />MM /DD/YYYY I MM /DD/YYYY <br />FROM 04/01/2013 TO 1 06/30/2013 <br />Form Approved <br />OMB No. 2040-0004 <br />DMR Mailing ZIP CODE: 81428 <br />MINOR <br />DELTA <br />DUGOUT POND TO N FORK GUNNISON <br />External Outfall ��,� <br />No Discharge�x <br />PARAMETER <br />i comfy under penalty of law that this document and all attachments were prepared under my dneenon or <br />super ts,on in ac.eordancewrtha.rystem designed to assure that quahfied personnel properly gather and <br />—bone the information submared Based on my inquiry of the person or persons who manage the <br />sy stem or those persons dueetly responsible for gathering the mforrtmuon, the ofomunon sub d is, <br />1 <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 />(� <br />penlamo <br />n <br />TYPED OR PRINTED <br />Oiland grease visual <br />SAMPLE <br />...... <br />.. .... <br />...... <br />...... <br />...... <br />MEASUREMENT <br />840661 0 <br />Effluent Gross <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 PRINC PAL EXECUTIVE OFFICER <br />i comfy under penalty of law that this document and all attachments were prepared under my dneenon or <br />super ts,on in ac.eordancewrtha.rystem designed to assure that quahfied personnel properly gather and <br />—bone the information submared Based on my inquiry of the person or persons who manage the <br />sy stem or those persons dueetly responsible for gathering the mforrtmuon, the ofomunon sub d is, <br />1 <br />11 <br />�f` j Y - — <br />TELEPHONE <br />DATE <br />' <br />1q <br />�f1VIV0� VYl�tvt4 <br />to the best of my knowledge and belief, toe, accurate and complete am aware that there are significant <br />f orsn brommgfalsemr�at on• meladmgthepossib, lityoffineand'mp^annrnen'forknow' <br />GNATUREOFPRINCIPA EXECUTIVE OFFICER OR <br />AUTHORIZED AGENT <br />AREA Code <br />NUMBER <br />MM DD <br />(� <br />penlamo <br />n <br />TYPED OR PRINTED <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SETTLEABLE SOLIDS LIMIT WAIVED FOR10 -YR, 24 HR PRECIP EVENT SUBJECT TO BURDEN OF PROOF REQUIREMENTS INPART 1.B.6. ANY ADDITIONAL DATA SHALL BE SUPPLIED TO THE DIVISION WITHIN 48 HOURS. <br />EPA Form 3320 -1 (Rev.01 106) Previous editions may be used. Page 2 <br />