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MAY/12/2017/FRI 05: 04 PM FAX No, P, 002 <br /> GENFAAL PERMU APPLICATION For Agency Usie Only <br /> STORMWATER,DLSCHARGES <br /> ASSOCIATED WTTA C'O R-5 0 . <br /> SAND AND GRAVEL PRODUCTION <br /> OPERATIONS(AND OTIMR Date Received <br /> NONMETALLIC MINERALS Year Month Davy <br /> EXCEPT FUEL) <br /> ( Na C0G-5"1Q1 <br /> Please print or type. Do not attempt to complete this form beibre reading the iusuwtions. <br /> 1. Is this the correct application for yovw fatty?? This application is only for the discharge of stormwatear. <br /> DO YOU dfschMge any of*e following process generated wastewaters from your facihitY? <br /> _aLNo Yes Product wash waters <br /> )()( No Yes ltilahitenanWequipment wash waters <br /> _2QyNo Yes Transport waters(e.g.,slurries) <br /> )2 No Yes Scrarbber waters(crashers or classifiers) <br /> )0( No Yes MW dewawnng(ground water au/vr runoff from the.mime) <br /> If you answered,_es,to any of these questions,do not complete this application. You must instead complete the Process <br /> Water and Stormwater Diiecharges Associated with Sand and[gavel application for this facility,which is available from <br /> the Division. <br /> 2. Name and address of permit applicant: <br /> GamgauyName: DANIEL J. GAUDREAUT& BARBARA J. GAUDREAULT dba BIG "G" GRAVEL PIT <br /> Fularal Tw-Tayer(oar Employer)M* — — — <br /> A+<aa'tmg Address: P.O. BOX 69 <br /> City,State and Zip Code- ELV-ABET H, CO 80107 <br /> Phone Numb,-r.( 303 ) 43 5-3081--- Who is applying for the permit? Owner )()( Operator <br /> Local Contact(!]SI I/liswith hcili4j). <br /> Titic:DANIEL,J. GAUDREAULT OPFRATOR/OWNERNmnbeF t 303 1 435-3081 <br /> 3_ Location of the facility: <br /> Street Address: 61000 EAST US HWY 50 <br /> City,State and np Code. BORNE, CO CO 81025 <br /> county: PUEBLO Name of fact itq._SIG "G" GRAVEL PIT <br /> LW,d Location(Township,Pangs,mcdon, 114 section):SEC- 25&26,T 21 S, R 61 W,6th P.M., PUEBLO CNTY,COLO, <br /> LaQu&and tu&: 38.18730 Deg. North, 104.20030 Deg. West <br /> Type of]:aca7ity__)Q�_New(beginning operations af4w 10/1/92) Existing(as of 10/1/92) <br /> 7/93/sg -l- <br />