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i <br />4. Standard industrial Classification (SIC) Code(s) for this facility. (Include up to four, in order of importance. See Appendix A.) <br />a) ~ ~ o b) ~_ c) I ~ d) <br />5. Receiving Stream: The name of the receiving stream(s). (If discharge is to a ditch or storm sewer, also include the name of the ultimate <br />mceiving waters.) <br />6. Industrial Activity: Describe the primary industrial activities which take place on site (e.g., sand and gravel mining, gypsum mining, sand washing, <br />gravel crashing, stationary or mobile asphaldconcrete batch plants, etc.). Indicate the status of the facility (active, inactive, being reclaimed, etc.) <br />?. Other environmental Permits: Does this facility currently havc any other environmental permits, or is it subject [o regulation, under either of <br />the following programs? <br />Penni[ Name Yes No Applied For, Date Permit No. <br />a.) Colorado Division of Minerals and Geology <br />formed MLRD) V <br />A f ~~~ .. O °) <br />CT• ,+~, <br />'~t~ t-`r'~~ ~~ <br />b. Under and In ection Contml <br />c J Dredge or fill permit under Section 404 of the Clean <br />Water Act CWA Arm Co s of En 'veers <br />d. Resource Conservation and Recov Act RCRA <br />e. CDPS Stormwater <br /> <br />f) Colorado State Air Pollution Emission may) <br />/` <br />~ ~ ~ ~ ~ ~t ~7 ~/~° <br />~~ ~~~ / ~ / 1 <br />g.) Other <br />If Yes to item 7.a), please include Colorado Division of Minerals and Geology (Mined Land Rerdamadon Board) permit anniversary date: <br />