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6� <br />1/ STORMWATER ANNUAL REPORT - SAND AND GRAVEL <br />COLORADO DEPT. OF PUBLIC HEALTH & ENVIRONMENT <br />Water Quality Control Division <br />WQCD -P -B2 } y I — (Q $O <br />4300 Cherry Creek Drive South <br />Denver, Colorado 80246 -1530 <br />Make enough copies of form for each reporting year. Or go to <br />http: / /www. cdphe. state. co. us/wq /Permits Unit /stormwater /industrial. httnl <br />Permittee (Company Name): <br />RECEIVED <br />"M 19015 <br />DIVISION Or RECLAMATION <br />MININGANDSAFETY <br />Check if this is a <br />new name, address, etc. <br />0 <br />Facility Name: % \; G:QAf e__k 13 <br />Mailing Address: _10n` 1`'V_ 3c-,-0 13 <br />Facility Phone Number: 13 <br />Permit Certification No. COR -34 0 - 4 '� - OR - COG -50 _ <br />(stormwater certification only) (stormwater and process water combined certificati(n) <br />0000 is not a valid entry for the certification number <br />Reporting Period: Jan. 1 -Dec. 31, 20 (Form is due by Feb. 15 of the following year) <br />* *Each section must be completed. Please print or type. ** <br />A. A report on the facility's overall compliance with the SWMP. (Include here a summary of any measures taken <br />to comply with your Stormwater Management Plan (SWMP), to fully implement it, changes or improvements <br />made in any of your Best Management Practices (BMPs), employee training, spills, other problems <br />encountered, etc. How is your plan working ?) <br />Were changes made to your SWMP? M No 0 Yes - Describe changes on a separate sheet. <br />B. A summary of each comprehensive stormwater facility inspection made, including date, findings, and action <br />taken. (The permit requires at least two comprehensive facility inspections per year - see page 8 of the permit. <br />Include here a summary of those inspections, plus any other comprehensive inspections made. It is not <br />necessary to summarize day -to -day inspections, unless significant problems were noted.) <br />First Inspection - Date I <br />L/k/A Findings, and action taken: <br />\ Ki Cb © rLO e'a 0�- rAQ <br />W C: Q� t nJ A-�\ e- %Ak <br />-V� w& i kq1�6' <br />rA �, '0-` pis <br />1 ; 1 <br />Note - form may be reproduced Page 1 of 2 arl /l lsg <br />