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i • STATE OF COLORADO GENERAL PERMIT APPLICATION STORNIWATER DISCHARGES ASSOCIATID WITH SAND AND GRAVEL PRODUCTION OPERATIONS (AND OTHER NONMETALLIC hIINRRAi S EXCEPT FUEL) This application is for use by all indusvial Stormwater dischazgers engaged in sand and gravel production operations, and other nonmetallic minerals (except fuels). This application is for both active and inattive mining operations. This form may be reproduced. Application Due Dates: At least thirty days prior to the anticipated date of dischazge, the owner (or operator if the owner does not operate the facility) of the facility shall submit an application as provided by the Water Quality Convol Division (the "Division"). Permit Fee: Do not send any oayrnent with this application. You will be billed once you aze covered under a permit. Application Completeness: All items of the application must be completed accurately and in their entirety or the application will be deemed incomplete, and processing of the permit will not begin until all information is received. One copy of the completed application shall be submitted, only to: Colorado Department of Public Health and Environment Water Quality Convol Division W QCD-PE-B2 4300 Cherry Creek Drive South Denver, Colorado 80222-1530 Attention: Permits and Enforcement Section If you have questions on completing this application, you may contact the Division at (303)+692-3590. INSTRUCTIONS Item 1 - Stormwater discharges: Submittal of this application is required from nonmetallic minerals production operations if there is a possibility of discharge to state waters of Stormwater that can come into contact with any overburden, raw material, intermediate products, finished products, byproducts or waste products loca[ed at the site of such operation, except as specified below. For example, runoff from haul roads, equipment storage azeas, or shipping and receiving azeas would be considered a Stormwater discharge. Process water discharges: Do not complete this application if you discharge any process waters. Process generated wastewaters include: product wash waters, maintenance/equipment wash waters, vansport waters, scrubber waters (crushers or classifiers), mine dewatering (groundwater and/or runoff), and Stormwater runoff which mixes with process generated wastewater prior to sampling. If your discharge includes any of these sources, you must complete the Process Water and Stormwater Discharges Assoaated with Sand and Gravel application instead, which is available from the Division. Item 2 - Provide the name and address of the permit applicant, including the company name, local contact, and mailing address. Indicate whether the applicant is the owner or operator of the facility. Include the applicant Federal Taxpayer Identification or Employer Identification number (this is a nine digit number in all cases). This number will be used as an identifier for billing purposes. 7/4lleg