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For each outfall provide the latitude, longitude and receiving water end indicate the method used b derive this information. Use additional sheets if necessary. <br />Please refer to instructions. <br />^' 666x1 Positoning System (QPS) unit accurate to within 30 yaraa. <br />^' Global Positioning System (6PS) unit accurate In greater then 30 yards. <br />^' Global Positioning System (6PS) unit aceuracy udmown. <br />^' Point on oritinal USES topographic map. <br />^' Engineering dmwing/plen with latitude and bnghude roference. <br />X Other. ggpds were sprveved. <br />Bath House and Sanitary Wastewater. Ts [hero a bath house at this facility? i~o ~- Yes <br />Are there ®nitary wastewater &cilities or sanitary treatment systems at this facrlity7 I~~ Yes <br />ff ~ b either gpest6n, what 6 the dtspmitlon of any wasenrahn and sludge genenaed? <br />DBehes and Storm Seven: L any receiving w~bervrdirsbsd in item 22 a ditch or atone sewer? No Yes See Item 40. <br />Certified Operator. Do you have a certified operator? No Yea U](~v please list name(s), artlikation number(s) and kvel(s} For infomtation <br />regarding required certification, contact the Colorado Plant Operators Certification Board at (303) 692-3500. <br />Not ApoBcabk <br />Discharge QuaBty: Analytical data for the paremehtia specified in the table beginning below and continuing on the next page, unless waived by the Division, <br />shall be wbmithd for at least one gmb sampling of each discharge point which is not sWdy made up of surface runoff a domestic wastewater as well as smote <br />waters upeheam of each discharge. Upstream data should be from non-rrrnoff periods, to the extent possible. Instream sampling is not roquircd if upstrcazn <br />flow is intermittent or reproaenlative ¢rstream data exist on file. For new mines, please submit a minimum of one year data for those parameters listed below. <br />Sucb data must have been obtained on at least a quarterly beets and moat be rofledive of the water quality prior to any mining activity. Sce bsWCtions. If this <br />is an application for renewal, reduced sampling may lx appropriate, contact the Permits Unit at (303) 692-3500. ~ - <br />Not Applipbk. Upstream Bow is 6termitteat. <br />The following choices for the data acquisition are lined in order of preference. Please check the box that applies 6 the method used for collection of the <br />locetional data of your Facility and Dkeharae po6ts. <br />