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, • ~ ~' <br />..~ <br />F. 04 <br />STORMWATSR DIS~eR~ PERMIT APPLICATION. Page 2 <br />5. Do you have any other existing environmental permits, such ae RCRA <br />(Hazardous Wastes), UIC (Underground Ir~,iection of Pluids), PSD (Air <br />Bmiasione from Proposed Sources), or any other environmental peratita? Clive <br />the number of each presently effective permit or the number of each .permit <br />that hea been applied for presently. C1L4~- $.t~r1t~~ ~f4 p~~LS- <br />6. Iadicnte the SIC (Standard Industrial Classification) Codes that are <br />applicable for your facility. List the SIC Code numbers in descending <br />order of significance, where the #irat SIC Code is the moat applicable <br />(the most used activity) for your facility_ <br />a. ~~_ <br />b. <br />c_ <br />d_ <br />7, flap: Attach to this application a topographic map of the area extending <br />to at least one mile beyond property boundariea_ The map must show the <br />outline o£ the facility, the location of each of its exietina and <br />proposed intal~e sad discharge structures, each of its hazardous waste <br />treatment, storage, or disposal facilities, and each yell where it insects <br />fluids underground. Include all springs, revers sad other surface water <br />bodies in the map area. If possible, the map should be an <br />8 1/Z by 11 inch size, from a 7-1/2 or 15 minute OSGS quad sheet or a map of <br />comparable scale. A north arras shall be shown. <br />8. Nature of Business (provide a brief description; include es as attachment if <br />more apace is required) : Sgndat~.on „A~~ T~rv~ <br />9_ I certi£:y under penalty of lavr that I have personally examined and am <br />familar .with the information submitted in this application and all <br />attachments and that, balled on my in3uirv of those individuals immediately <br />reaponailble far obtaining the information, I believe that the information is <br />true, ac~wrate and complete_ I am aorare that there are significant <br />penaltie~a for submitting false information, including the passibility of <br />fine or :imprisonment _ <br />A <br />NAME <br />~~ <br />B, a^I'GNATURH OF OPERATOR RATS <br /> <br />