PERMFILE53319

• Permit No: M1995012
• IBM Index Class Name: Permit File
• Section_Exhibit Name: EXHIBIT G OTHER PERMITS
• Media Type: D
• Archive: No

ENERAL PERMTI' APPLICATION
STORMK'ATER DISCHARGES
ASSOCIATED WITH
SAND AND GRAVEL PRODUCTION
OPERATIONS (AND OTHER
NONMETALLIC MiNRRAi C
EXCEPT FUEL)
(Permit No. COG-500000)
Please print or type. Do not attempt to complete this form before reading the instructions.
1. Is this the correct application for your facility?? This application is only for the dischazge of stormwater.
Do you dischazge any of the following process generated wastewaters from your facility?
No ^ Yes Product wash waters
No ^ Yes Maintenance/equipment wash waters
0 No ^ Yes Transport waters (e.g., slurries)
a^ No ^ Yes Scrubber waters (crushers or classifiers)
X^ No ^ Yes Mine dewatering (groundwater and/or runoff from the mine)
If you answered Yes to any of these questions, do not complete this application. You must instead complete the
Process Water and Stormwater Discharges Associated with Sand and Gravel application for this facility, which is
available from the Division.
2. Name and address of permit applicant:
Company Name: CECIL C. POWELL
Federal Taxpayer (or Employer) IDak: 524_58_1447
Mailing Address: P • 0. Box 23
City, State and Zip
Phone Number: ( 303) 374-2329
Local Contact (fatniliaz with facility): CECIL C.
Tide: Oh'NER
Phone Number: ( 303 ) 374-2329
3. Location of the facility:
Street Address: P • 0 . Box 2 3
City, State and Zip Code: DINOSAUER Co 81610 _
County: MOFFAT Name of facility: CECIL C. POWELL GRAVEL PIT
Legal Location (township, Range, section, 1/4 section): NE 1/4 Section 9, T3N, R103W 6TH P.M.
Latitude and Longitude: 589'40 ~ 49W. S0019 ~ 11 ~~ E
Type of Facility: X^ New (beginning operations afrer 10/1/92) ^ Existing (as of 10/1/92)
Who is applying for the permit? LJ Owner LJ Operator
POWELL
FOR AGENCY USE ONLY
Certification Number
C O G- 5 0
Date Received Fce Category

year Month Day
7/93/eg -1-