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Additional Mouimring: All applcanis must review the paramears listed in Appendnt A and Appends B to this appGcatbn end mdieabe whether any of O~ese polhrtants are imown or believed to 6e present For every po0mmt expelled m be discharged, the applicant must briefly destxibe We reasons the pomrtant is expetYed m 6e discharged and report any quantitative data for the po0umet Nat Aomlitabk CDMG Monitoring: Please submit a copy of stmtmmies of all water quality monitoring data of outfalls or receiving streams for which data has been gathered ov« the last five years for the mhting site ®d which is requbed by the Cobmdo Division of Minerals and Goobgy. If not abeady submitted to the Divison, the plea which demos the monit«ing frequency, type, bcatbas and method of analysis must also be submitted. If these data are voluminous, please contact the Divmoa A conv of the summarv tort of the 2002 Anrnai Hvdrokek 12ceort is amoeoded. Additional intormatioo is available as rixded. Bulk Storage: Do you have bulk storage of diesel fue4 gasolhte, soWents «other hamrdous materials on sme7 Imo X Yes Its briefly list materials, Weir gaanfky, measures mken to ensure War spills do not eakr state waters and mdkale Weir keatko an site skateh, ~ 12. For renewal applications, list the date when the most recent Materials Contammmt Plan was sutaniroed Activity Daratkn: Rfien did the mhrirrg operation oommenceT 1982 Esthoated life of the activity - mioine hu teased yeas. Pollntbe Prevention Plans: Please desarbe arty po0ution prevention or beat management phms ament(y m plane that mould tesub m We bnprovement of water glralhy. These cook include solvent recycling pmgmms, thabcriel conmurment procedures, edueatbn, etc. Sediment Pomda #1 and 2 tonmio a0 runoff from We site. We storm runoff lxin¢ W e ooiv source of oollntioa. Fled reedamatioa of We Bite will intornonk revt¢etation Wat wiB redna kveb of sediment ¢mented dario¢ storm eveata Hslorit Drainages: Dues histoic drahtage exist at the site, whle6 is ~t exwaed antler a CDPS pertnLL? Yes ~ If so, please provide a map showhrg the btatbn of the diadrmges and copies of all analytical inforroation ce the discharges. Phase sample the discharges for the pmameters tis~0ed in treat 26 and srtbmh those resuhs. Ibis requ¢ement may be waived by the Division if suitable ti80a on the dischmge's historic quality exists. Additional Intormatiou: Please include soy other infntmation that you feel the Division should be aware of m ehafting this permit. Include 6ere,any tbw or stream dam that you would hke considered. Attach pages as necessary. Stormwater Dieehaegn: All aerive and inactive opal mines must be covered by a st«mwmer pemriL 6`. your fircr7r'ty does trot abeady have a stormwater pemrrt, complete Appendvr C-1 and submh m additbn m this appi~tion. A1.S0, SEE IlTEM 38. Stormwater Managemwt Plea: This dam applies lD alt renewal permit applicants where the fac0ity has stormwater mvetage through a oombhred process water/s[ormwater permit (individual or (,fenenal) or through separa0e txocess water and srormwater permits (and may apply to dher facifitiev). la these cases, the petmittee shall sign the foibwing oerti6eatbn statement If a SWMP has trot been prepared, ace the SWMP guidance document in Appendix C-2. 't oertidy order pemby of law that ^ c«aplete Smemwata> Plea. ~m aoafoamace with Appeod'oc C-2 oCWie epplinfiw, tees bxo prepared f« my tec0iry. Eased m ma' inWQY afthe pemor «persom was narrege the synan, «Wose persons dnecUy rspoasrble ~ gadrering the mbrremdon, We Swt~ h. m the best of my knowledge end hatter, nue, eecurate and oomple0e. I em ewue that Were ere sigoi6ont peaeltirs for fahely oatityiag the oaarpie0eoevss ofseid SWh4', mcludmg We poaaibility of tore and ~~ Sigarime of Permit /A~ppl' .Q/~ ~n nC~l'A P!.'u l~s ~~+. rRt3~de-,.~ o Kra f-~~~q~ ~'~ /i-~~-o 3 Date Signed Title ~jeS~~„-~"