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FEE INFORMATION The Annual Fee for this certification is $121 (category 07, Subcategory V-6 Sand and gravet without process discharge— stormwater only, per CRS 25-8-502). Do Not Pay This Now..Annual fees are sent to the legal or billing contact in July. GENERAL INFORMATION • Changes to the certification: Any changes that need to be made to the certification page - changes in sampling location, monitoring requirements, etc., must be submitted using the "Permit and Certification Modification form" available on the Division's website, www.coloradovvaterpermits.com, and signed by the legal contact. • Monitoring and requirements: Monitoring must occur at the frequency established in the permit certification. Weather conditions may not always allow the permittee to collect a sample during business hours; however, the monitoring frequency established in the permit certification must be met. For facilities required to conduct chemical monitoring, the Division strongly recommends that the permittee contact a tab prior to setting up a sampling program. Stormwater monitoring location(s), i.e., outfalls, are locations where stormwater exits the facility property, including pipes, ditches, swates, sheet flow and other structures that transport stormwater. The permittee must modify the facility SWMP to include a description of all stormwater outfalls. Stormwater outfalls must be representative of the facility's stormwater discharge. A facility may require more than one stormwater outfall where pollutant sources vary across the facility. • Annual Reports: The permittee must complete an Annual Report form and submit it to the Division by February 28 of the following year. This form is available on the Division's web site (www.cotoradowater-permits.com). • Stormwater Management Plan- See Parts I.L. and I.M. of the permit: An existing permittee authorized under the previous versions of the Sand and Gravel permits shall modify the existing SWMP to comply with the requirements of the renewal permit within 180-days of the facility permit certification effective date. • Termination requirements: The permittee may initiate termination of permit coverage by submitting a "CDPS Permits and Authorization Termination Form."To terminate the permit, the permittee must meet all termination requirements as stated in the general permit (Part I.A.7). This form is available on the Division's web site (www.cotoradowaterpermits.com)and must be signed by the legal contact. CHEMICALS The permittee did not specify any chemicals for use in waters that may be discharged from the facility. On this basis, no chemicals are approved under this permit certification. Discharges with chemical addition (including, but not limited to chemical additions at any point in the treatment process, release agents, etc.), are eligible for coverage under this permit only if the Division approves the use of the specific chemicat(s) and provides notification of such approval to the permittee. To request Division approval, the permit applicant must submit a modification request that includes a list of proposed chemicals, the purpose of the use, dosage rates, and the most current Material Safety Data Sheet (MSDS) for each chemical. In granting the use of such chemicals, the Division may impose additional limitations and monitoring requirements in the permit certification. Until approved, use of any chemical in waters that may be discharged could result in a discharge of pollutants not authorized under the permit. CERT1FiCATION RECORDS INFORMATION The table below provides the information contained in Division records for this certification. Any changes to the contacts listed below must be provided to the Division on a "Notice of Change of Contacts" form, and must be signed by the legal contact. This form is available on the Division's website at www.cotoradowaterpermits.com. Facility: Elbert Co Pit Elbert County Industrial Activities: Construction sand and gravel operations. SIC Code(s): 1442 Legal Contact (receives all legal documentation, pertaining to the permit certification, including invoice; is contacted for any questions relating to the facility; and receives DMRs as appropriate): Robert Christian, Operator Phone number: 719-352-6625 Christian Construction Inc Email: 16230 Reata Rd Christian_construction@hotmail.com Peyton, CO 80831 Fact sheet Page 2 of 3 4300 Cherry Creek Drive S., Denver, CO 80246.1530 P 303.692-2000 www.cotorado.gov/cdphe/wgcd John W. Hickentooper,Governor I Larry Woik,MD,MSPH, Executive Director and Chief Medicat Officer i3