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Permit Number: 1 nRn 1 17.r, <br />AIRS ID Number: 006 / ! <br />Section 2- Requested Action <br />❑ NEW permit OR newly -reported emission source (check one below) <br />❑ STATIONARY source ❑ PORTABLE source <br />-OR- <br />❑ MODIFICATION to existing permit (check each box below thct applies) <br />❑ Change fuel or equipment ❑ Change company name ❑ Add point to existing permit <br />❑ Change permit limit ❑ Transfer of ownership' ❑ Other (describe below) <br />-OR - <br />❑� APEN submittal for update only (Blank APENs will not be accepted) <br />- ADDITIONAL PERMIT ACTIONS - <br />❑ Limit Hazardous Air Pollutants (HAPS) with a federally -enforceable limit on Potential To Emit (PTE) <br />❑ APEN submittal for permit exempt/grandfathered source <br />Additional Info & Notes: N/A <br />3 For transfer of ownership, a completed Transfer of Ownership Certification Form (Form APCD-104) must be submitted <br />Section 3 - General Information <br />General description of equipment and purpose: Fugitive Dust from Stockpiles, <br />Truck Haulage and Other Operations, and Disturbed Areas <br />Manufacturer: NSA Madel No.: N/A Serial No.: N/A <br />Company equipment Identification No. (optional): N/A <br />For existing sources, operation began on: August 16, 2012 <br />For new or reconstructed sources, the projected start-up date is: <br />0 Check this box if operating hours are 8,760 hours per year; if fewer, fill out the fields below: <br />Normal Hours of Source Operation: hours/day days/week <br />Seasonal use percentage: Dec -Feb: <br />weeks/year <br />Mar -May: Jun -Aug: Sep -Nov: <br />'® COLORADO <br />2 <br />