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<br />COLORADO DEPARTMENT OF HEA1.Tf1 <br />Water Quality Control Division <br />4210 East 11th Avenue <br />Denver, Colorado 80220 <br />(303)+320-8333, Ext. 3740 <br />999 <br />APPLICATION FOR TRANSFER <br />AND ACCEPTANCE OF TERMS <br />OF A COLORADO PERMIT <br />I hereby apply for transfer to me of this Colorado Permit No. C06-5( 22 (formerly <br />which was issued to ~,rxvjPll R,~ntr,P,-c r.,C, I have reviewed this OD-0035629) <br />permit and accept responsibilities, coverage and liability, <br />effective '~~ a~(T 7~j~¢~j <br />NEW OWNER/OPERATOR ~;JOr /~o.-(lt~ _GftC 1 nc1lc ~,.t_~J~tti'E~a'~n <br />f 1 <br />Facility Name <br /> <br />Mailing Address 3600 lJIS-F 'O~/~S`f~'tt,{1 ~ ~.0. ~c ~I67~ .(Jr~l~t~ ~vloi'a..~a 8063E <br />Ciry ~j-/'«/.Qy State ~J~oP~a Zip Code~063Z County_~ <br />Telephone Number (3a3) 353 - Soo.2 <br />Autl <br />Sig <br />Tit <br />Date 6~a~~J <br />AS previous owner, I hereby agree to the transfer of the above referenced <br />permit and all responsibilities thereof. <br />PREVIOUS OWNER/OPERATOR <br />Facility Name <br />AuL' <br />Sig <br />Tit <br />Da t <br />~'CJ ~ <br />