2026-01-21_REPORT - M1981043 ‎(3)‎

• Permit No: M1981043
• IBM Index Class Name: Report
• Doc Date: 1/21/2026
• Doc Name Note: CDPHE Stormwater Insp rpt
• Doc Name: Annual Report Supplemental Information
• From: CDOT
• To: DRMS
• Annual Report Year: 2025
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

SAND AND GRAVEL REPORTING
(Required for the CDPHE Annual Report) Revised: 4118/18
Facility Location: Certification No.:
North of Douglas Pass Pit COG502081
Facility Location: Weather Conditions:
US 139 and Rope Canyon, Rio Blanco County DRY
Monitor's Name: Date of Inspection:
KIRK MARDESEN 07/07/2025
COLORADO
Departmentopomtion
DBMS Permit No.:
M-81-043
SWAP Administrator Name:
KIRK MARDESEN
CDOT Work Order Number:
Facility Inspection — Stormwater Only
This inspection is being performed in compliance with Part I.J. of the Stormwater Discharge Associated with Sand and Gravel Productions. If an
inspection(s) was not conducted in accordance with the required frequency, attach an explanation of why.
9. Was this the required one time annually the monitoring was conducted during a runoff event? C'es !0 No
2. Has the site created any process water (screen washing or transport slurry) or mine dewatering? OYeS O No
OActive Site: Require 4 inspections annually (Quarterly). Date that facility became active: U N KNOWN
0 Inactive and Unstaffed Site wl No Exposure: Require 2 inspections annually (Spring/Fall) and a signed Certification of No Exposure (Page 4 of 5)
signed. Inactive requires that no activities have taken place at the facility (except inspections) from the date of the last inspection listed here:�
VInactive and Unstaffed Site wl Exposure: Require 6 inspections annually (At least 20 days apart and no more than 2 months apart). Inactive requires
that no activities have taken place at the facility (except inspections) from the date of the last inspection listed here:
Control Measures at Time of
Inspection
Control
Used?
Measure
(t)
Maintenance
Required?
(2)
Additional Control
Measures Needed?
(3)
Comments — Include the location of
control measure and description of
corrective actions required.
Date of
Correction
(4)
Clean Water Diversion
Y
N
K
Y
N
Y
N
X
Sediment trap/basin
X
v
X
Perimeter control: Berm, Silt
fence, Erosion Lops, Bales
X
X
X
Check dam
X
X
Outlet protection
v
V
Vegetative Buffer
v
X
Landform
V
v
v
Seed/Mulch
V
v
X
_ `
SeedlSoil Retention Blanket
Other: (examples -vehicle tracking
ad, fencin , etc.
�
X
(1) Indicate whether the control measure
(2) Indicate whether the control measure
stated in the permit, repairs or maintenance
(3) Indicate whether any new or different
the next anticipated storm, but in
(4) Enter the date that maintenance,
listed
requires
control
no case
repair, or
is in use at
any type
identified
measures
more than 60
replacement
this facility.
of maintenance
shall be completed
are needed
calendar
of control
such
immediately.
on the
days after
measure
as repair or
project. As stated
the inspection.
is completed,
removal of accumulated
in the permit,
or that an new
sediment; or if the control measure has
revised control measures shall be implemented
type of control measure is installed.
failed. As
before
Page 1 of 5