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Permit Number: AIRS ID Number: / ! <br />Section 2- Requested Action <br />✓❑ NEW permit OR newly -reported emission source <br />-OR- <br />❑ MODIFICATION to existing permit h+ ,, k Toch box below that applies) <br />❑ Change fuel or equipment ❑ Change company name ❑ Add point to existing perm -t <br />❑ C'!anu,e permit limit ❑ Transfer of ownership' ❑ Other mdescribebelow) <br />-OR- <br />❑ APEN submittal for update only (Please note blank APENs will not be accepted) <br />- AoDirnor At. PERMIT Arnoms - <br />❑ APEN submittal far permit exempt/grandfathered source <br />Additional Info @ Notes: <br />' For transfer of ownership, a completed Transfer of ownership Certification Form (Form APCD-1D4I must be submitted. <br />Section 3 - General Information <br />General description of the activity: ladditianalty, please provide a Slte map) <br />Sand and gravel mine, using dozer, excavator, scrapers, loader, haul trucks and conveyors. <br />Washing, screening, crushing and processing construction aggregates. <br />For existing sources, operation began on: <br />For new or reconstructed sources, the projected start-up date is: October 20'17 <br />Normal Hours of Source Operation: a hours/day 6 days/week 52 weeks/year <br />Seasonal use percentage: Dec -Feb: 10% Mar -May: 30% Jun -Aug: 30% Sep -Nov: 30% <br />Commodity Produced: (clxck eacir twx below that applies - as indkoted on the applicable Atvlsian a/ Minerals and Geelegy Permit) <br />0 Aggregate / Sand and Gravel <br />❑ Stone <br />❑ Coat <br />❑ Minerals or Metals (type) <br />❑ Other 1piease describe) -� <br />