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Application For Discharges Associated with Sand & Gravel Mining And Processing www.coloradowaterpormits.com <br />B. Permitted Facility Information <br />Type of Facility a New (beginning operations after 10/1/1992) ❑ Existing (as of 10/1/1992) <br />Name of Facility Blue Valley Pit <br />Location of Facility <br />Street Address (or cross streets): 3375 Colorado State Highway 9 Silverthorne, Grand County <br />City (if unincorporated, so indicate): County: <br />State and zip code: Colorado 80498 <br />Latitude and Longitude (approximate center of facility to nearest 15 seconds, using one of following formats and NAD 83 coordinate <br />system : <br />Latitude: Longitude: (e.g., 39 °42'11 ", 104 °55'57 ") <br />degrees /minutes/ seconds <br />OR <br />Latitude: 39.961 <br />Longitude: <br />degrees/ minutes/ seconds <br />- 106.349 <br />degrees (to 3 decimal places) degrees (to 3 decimal places) <br />C. STANDARD INDUSTRIAL CLASSIFICATION (SIC) CODE(S) FOR THIS FACILITY <br />(See Appendix A - include up to 4 in order of importance). <br />a. 1442 b. C. <br />D. DESCRIBE THE INDUSTRIAL ACTIVITIES WHICH TAKE PLACE ON THIS SITE <br />(e.g., 39.703 °,104.933') <br />d. <br />Sand and Gravel Mining and processing for Highway Construction on State Highway 9 <br />E. RECEIVING WATERS <br />(If discharge is to a storm sewer system, ditch, or manmade conveyance, include the name of the ultimate receiving waters.) <br />Immediate Receiving Water(s): Unnamed Tributaries <br />Ultimate Receiving Water(s): Blue fiver <br />Are the receiving waters indicated above a storm sewer system, ditch, or manmade conveyance? <br />e NO ❑ YES <br />If discharge is to a storm sewer system, ditch, or manmade conveyance, approval from the owner of the system must be obtained <br />before discharge. <br />F. MAP (Provide as an attachment to the application <br />Map: Attach a map that indicates the site location and that CLEARLY shows the boundaries of the area subject to the application. Maps <br />must be no larger than 11 x 17 inches. <br />Map attached? ❑ NO a YES <br />G. SITE SKETCH (Provide as an attachment to the application) <br />A legible general sketch of the site MUST be submitted, showing appurtenant facilities (buildings, ponds, diversion ditches, stockpiles, <br />etc.), stream location, numbered discharge points, sampling and flow monitoring points. The map must be no larger than 11 x 17 <br />inches. The outfalls shall be labeled to correspond with the numbers listed in the Outfalls list. <br />Site Sketch attached? ❑ NO a YES <br />page 4 of 7 revised Jan 2014 <br />