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July 23, 2014 <br />RENEWAL APPLICATION SUPPLEMENT for COGS00000 and COR30000 <br />Colorado Department of Public Health and Environment <br />Water Quality Control Division <br />4300 Cherry Creek Drive South WQCD -P -82 <br />PERMITTEE AND FACILITY <br />Organization: <br />Responsible Position (Title) <br />Currently Held By (Person): <br />Telephone No.: <br />Mailing Address: <br />Name of Facility: <br />Facility Location: <br />Denver, Colorado 80246 -1530 <br />Collins Morehead LLC <br />President / Managing Partner <br />Dan Collins <br />480 - 206 -2037 <br />PO Box 3055 <br />Telluride, CO 81435 <br />RECEIVED <br />DEC 0 2 2014 <br />DIVISION OF RECLAMATION <br />MINING AND SAFETY <br />Deep Creek Placer <br />201 Deep Creek Rd., CR639, Old Town of Lime <br />San Miguel County <br />Facility Latitude and Longitude: Latitude: 37.9583 Longitude: - 107.933333 <br />Facility SIC Code: 1422 (Crushed and Broken Limestone) <br />REQUIRED CERTIFICATION SIGNATURE [Reg 61.4(1)(h)] <br />"I certify under penalty of law that this document was prepared under my direction or supervision in <br />accordance with a system designed to assure qualified personnel properly gather and evaluate the <br />information submitted. Based on my inquiry of the person or persons who manage the system, or those <br />persons directly responsible for gathering information, the information submitted is to the best of my <br />knowledge and belief, true, accurate and complete. I am aware that there are significant penalties for <br />submitting false information, including the possibility of fine and imprisonment for knowing violations." <br />July 23, 2014 <br />Signature of Responsible Person Date Signed <br />Daniel L. Collins President <br />Name (printed) Title <br />1. Site Map (see previously submitted map from Feb. 2013) with legend addressing pertinent items: <br />a. Mining site boundaries <br />b. Access and haul roads <br />c. Stormwater outfalls and an outline of the drainage area of each stormwater outfall <br />d. An estimate of direction of flow <br />e. Materials handling areas <br />