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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 />(Permit No. COG-500000) <br />For Atency Use Only <br />COR-50 ___ <br />Date Received <br />Year Month Day <br />Please print or type. Do not attempt to complete this forth before reading the instructions. <br />1. Is [his [he correct application for your facility?? This application is only for [he discharge of stormwater. <br />Do you dischazge any of [he following process generated wastewaters from your facility? <br />No ^ Yes <br />® No ^ Yes <br />No ^ Yes <br />® 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 [he mine) <br />If you answered Yes to any of these questions, do no[ complete [his application. You must instead complete the Process <br />Water and stormwater Discharges Associated with Sand and Gravel application for this facility, which is available from <br />the Division. <br />2. Name and address at permit applicant: <br />Company Name: ACA Products. Inc. <br />Federal Taxpayer (or Employer) ID#: ~ ~ ~ 4 1 5 4 3 5 <br />Mailing Address: P.O. Box 1887 <br />City, State and Zip Code: <br />Phone Number: ( 719) 395-379(1 Who is applying for the permit? U Owner ~ Operator <br />Local Contact (familiar with facility): <br />Tide: ~yP H t phi on Phone Number: ( 719 ) 395-3790 <br />3. Location of the facility: <br />Street Address: Nti~trePt ArlrlrPCa Mnltz Ranrh R~aA nff C~nnty Rnad 301 Legal Attached <br />City, State and Zip Code: Johnsons Villas?e, Co 81211 <br />County: ChaffPP Name of facility: River Park Recreation Access <br />Legal Location (Township, Range, section, 1/4 section):NEl/4ofNW1/4SectiOn27,T14S,R78W,6th P.M. <br />Latitude and Longitude: aft 4R' 32" N 106 06' 11" W <br />Type of Facility: ~ New (beginning operations after 10/1/92) ^ Existing (as of 10/1/92) <br />7/93/sg -1- <br />