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13EM Mining Operations APEN - Form APCD-222 <br /> Air Pollutant Emission Notice (APEN) and <br /> AT Application for Construction Permit <br /> All sections of this APEN and application must be completed for both new and existing facilities, including APEN <br /> updates. Incomplete APENs will be rejected and will require re-submittal. Your APEN will be rejected if it is <br /> filled out incorrectly, is missing information, or lacks payment for the filing fee. The re-submittal will require <br /> payment for a new filing fee. <br /> This APEN is to be used for mining operations(i.e. quarries, pits, or mines). This APEN may also be used to report <br /> haul road activities at non-mining facilities. Additional APENs may be required for process equipment located at <br /> the mine. A specialty APEN may be available for the process equipment(e.g. asphalt plant, crusher/screen, <br /> concrete batch plant, engines, etc.). In addition, the General APEN (Form APCD-200)is available if the specialty <br /> APEN options will not satisfy your reporting needs. A list of all available APEN forms can be found on the Air <br /> Pollution Control Division (APCD)website at: www.colorado.gov/cdphe/apcd. <br /> This emission notice is valid for five(5)years. Submission of a revised APEN is required 30 days prior to expiration <br /> of the five-year term,or when a reportable change is made(significant emissions increase, increase production, <br /> new equipment, change in fuel type, etc.). See Regulation No. 3, Part A, II.C. for revised APEN requirements. <br /> Permit Number: AIRS ID Number: <br /> [Leave blank unless APCD has already assigned a permit x and AIRS ID] <br /> Section 1 - Administrative Information <br /> Company Name': Uinta Mining LLC <br /> Mine/Pit Name: Skull Creek Sand Project <br /> Mine/Pit Location <br /> Mine/Pi[Location: <br /> approx. 2.7 miles NW county: Moffat <br /> of Massadona, CO <br /> NAiCS or SIC code: 1499 <br /> Mailing Address: 6602 Ilex Circle <br /> (Include Zip Code) <br /> Naples, Florida 34109 Contact Person: Robert Nead <br /> Phone Number: 239-825-2332 <br /> E-Mail Address2: basic@altoncoal.com <br /> ' Use the full,legal company name registered with the Colorado Secretary of State.This is the company name that will appear <br /> on all documents issued by the APCD.Any changes will require additional paperwork. <br /> 2 Permits,exemption letters,and any processing invoices wilt be issued by the APCD via a-mail to the address provided. <br /> Form APCD-222 -Mining Operations APEN - Revision 3/2019 1 ®® COLOR ADo <br />