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Item 3 - For the approximatester point of the property, both types otlcriptions (legal, in terms of <br />Township, Range and 'k section, and longitudeflatimde, to the neazest 15 seconds) must be included. <br />This information is easily obtainable from a U.S. Geological Survey topographical map, available at <br />azea map stores. <br />Item 4 - The Standard Indtutrial Classification (SIC) Code or codes for the facility must be listed. SIC Codes <br />aze assigned according to the primary activities performed by a company. They aze often assigned for <br />insurance purposes or when a business registers as a corporation. Industries can also determine their <br />SIC Code by checking with their trade association, Chamber of Commerce, legal counsel, or local <br />library for the SIC Manual. See Appendix B. <br />Item 5 - Identify the receiving water. Receiving waters aze any waters which are contained in or flow in or <br />through the state of Colorado (except for water withdrawn for use until use and treatment have been <br />completed). This definition includes all water courses, even if they aze usually dry. <br />If stormwater from the industrial site enters a storm sewer system or ditch, identify that system and <br />indicate the ultimate receiving water for the storm sewer or ditch. Note: a stormwater dischazge permit <br />does not allow a dischazge into a ditch or municipal storm sewer system without the approval of the <br />owner/operator of that system. <br />Item 6 - Describe the primary industrial aaivities at this facility, such as mining, gravel washing, crushing, or <br />batch plant operations. <br />Item 7 - Indicate whether or not your facility has or is subject to the following environmental permits: <br />a) If you currently have a dischazge permit from the Division for the dischazge of process water, <br />include the number here (CDPS -Colorado Dischazge Permit System; NPDES -National Pollutant <br />Dischazge Elimination System). Note that if your operation is currently covered under the <br />Division's general permit for sand and gravel operations (permit number COG-500000), then you <br />do not need to fill out this application. <br />b) Indicate your Mined Land Reclamation Board permit number here. The anniversary date of your <br />mining permit application to the Colorado Mined Land Reclamation Boazd is also required. <br />Item 8 - Completion of a Stormwater Management Plan (SWMP) is required prior to application. (Submittal of <br />the actual plan is not required) The permit application shall include a signed certification that the <br />SWMP has been completed. For a detailed list of SWMP requirements, see Append'u A of the <br />application. <br />Item 9 - The application must be signed to be coruidered complete. In all cases, it shall be signed as follows: <br />a) In the case of corporations, by a principal executive officer of at least the level of vice-president or <br />his or her duly authorized representative, if such representative is responsible for the over-all <br />operation of the facility from which the dischazge described in the application originates. <br />b) In the case of a partnership, by a general partner. <br />c) In the case of a sole proprietorship, by the proprietor. <br />d) In the case of a municipal, state, or other public facility, by either a principal executive officer, <br />ranking elected official, or other duly authorized employee. <br />7/93/eg -11- <br />