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<br />GENERAL PERMIT APPLICATION <br />STORMWATER DISCHARGES <br />ASSOCIATED WITH <br />SAND AND GRAVEL PRODUCTION <br />OPERATIONS (AND OTHER <br />NONMETALLIC MINERALS <br />EXCEPT' FUEL) <br /> <br />FOR AOHNCY USH ONLY <br />Certification Number <br />C O G- 5 0 <br />Date Received Fee Cate o <br />Year Month Day <br />(Permit No. COG-500000) <br />Please print or type. Do not attempt to complete this form before reading the instructions. <br />1. Is this the correct appGrstion for your facility?? This application is only for the dischazge of stormwater. <br />Do you dischazge any of Ute following process generated wastewaters from your facility? <br />No ^ Yes <br />No ^ Yes <br />^X No ^ Yes <br />^X No ^ Yes <br />No ^ Yes <br />Product wash waters <br />Maintenance/equipment wash waters <br />Transport waters (e.g., slurries) <br />Scrubber waters (crushers or classifiers) <br />Mine dewatering (groundwater and/or runoff from Ute mine) <br />If you answered Yom, to any of these questions, do not complete this application. You must instead complete the <br />Process Water and Stormwater Discharges Associated with Sand and Grave! application for this facility, which is <br />available from the Division. <br />2. Name and address of permit applicant: <br />Company Name: ROCKY FLAT GRAVEL <br />Federal'Taxpayer (or Employer) IDX: ~],=¢4~8,~ - - - - - . <br />Mailing Address: P • O . BOX # 16 5 _ <br />City, State and Zip Code: LA VETA, COLORADO 81055 _ <br />Phone Number: (~ i a 1 ~ a ~- 3 S ~ t Who is applying for the permit? ®Owner ^ Operator <br />Local Contact (familiaz with facility): Mrs. L. Otto Goemmer _ <br />Title: p~anAr Phone Number: (719 )742-3561 <br />3. Location of the farlGty: <br />Street Address: 7500 State Hiway #12 <br />City, State and Zip Code: La Veta, Colorado 81055 <br />County: Huerfano Name of facility: Rockv Flat Gravel <br />Legal Location (Township, Range, section, 1/4 section): SF 32-29-68 of 6th P.M. _ <br />Latitude and Longitude: nar_s C'nrhara Ouadranale 37° 30' 105.00° <br />Type of Facility: ^ New (beginning operations after 10/1/92) X^ Existing (as of 10/1/92) <br />7/93hy -1- <br />