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PerrMt Number. AIRS ID Number: <br />(Leave blank unless APED has already assigned a permit X and AIRS IDI <br />Will processkng (i.e., t rushfrlg, screening, etc.) occur an site( (yes/no) yes <br />If you answered 'No' above (i.e. no process ing/manufacturing equipment will be located on site) check the box <br />below and skip to page 6, Section 4G - Finished Product. <br />❑ Check this box If no process equipment is located on site. <br />List any addidmt emission sources and related controls (e.g. concrete batch plants, crushers/screens, engines, <br />conveyors and transfer points associated with process equipment, HMA plants, etc.) Additional APENs for any such <br />equipment may be required. The following Specialty APENs are avaltable. Form APCD-224 Concrete Batch Plants, <br />Form APCD-221 Crushers and Screens, Form APCD-233 Diesel Engines. If a Specialty APEN is not appropriate for the <br />additional equipment, use Form APCD-200 General APEN. <br />Additionally, complete the section below regarding crashing and screening performed an site. <br />Emission Source <br />(or "e) <br />Control Equipment Desai lon <br />Permit Number <br />(W -*M *o <br />portable crusher/screens <br />APEN supplied by the crusher contractor <br />portable Asphalt batch plant <br />APEN supplied by the Asphalt contractor <br />Primary Cm*ng <br />Maxirrxtm meshed per year (tom) /. •& &epb <br />Design prwm rate tmrnrhmr) y� <br />Dlratlon of daily crushiq (hewx) 9 <br />Sec"Wary Crustihg <br />Maxbmn awhed per year (tans) <br />Design process rate 1tmslhoaP) <br />Proposed control for cnWft <br />,2rmolst material <br />Z*Ater spray <br />❑ Enclosums (dmf. one wdW from below) <br />❑ete ❑ Partial <br />O Odd owdw <br />ScreenkWClaw"++s <br />Maximum screened per year (mm) a 5 C)0O <br />Design Process rate (oomlhow) YOO <br />Duration of deny screaft (haus) L9 <br />Secondary Scie ntWCtassityl% <br />Max* m screened per year (Dom) <br />Design process rate (taWhour) <br />Proposed control for screenin <br />t material <br />&Water spray <br />❑ Enclosure (draese one apaw ft m w w) <br />❑ Complete ❑ Partial <br />❑ other (Wedh) <br />Note: Completion of this section does not relieve the applicant from the requirement to submit APEN forms for <br />process equipment subject to APEN or permitting requirements. <br />Form APCD-222 - Mining Operations ADEN - Rev►sfon 7/2077 <br />DLO IIAD6 <br />5 1 A <br />Fir Irv. <br />