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c <br />FOR AGENCY USE ONLY .. <br />COAL MINING- <br />PROCESS WATER AND STORMWATER <br />DISCHARGE APPLICATION <br />II PERMIT NUMBER : <br />i~~r ~ r~ <br />.. ~ ~ ~ ~~ DATr'. RECEiVED~~ <br />' :YEAR..::..:.:.' MONTH.: DAY <br />PLEASE PRINT OR TYPE Do not anempt to complete this form before reading the accompanying inswctions. <br />New ^ or Renewal ~ If renewal, existing permit number: CO G-850027 <br />I. Name and Address of Operator: <br />Company Name: Oa';ridge Energy <br />Federal Taxpayer (or Employer) IDq: 8 7 0 2 B 7 1 7 6 <br />Mailing Address: 278 Sawyer Drive <br />Ciry,StateandZipCode: DuranSo, Co'_nradn 3)30i <br />Phone Number: f 970) 385-4451 Who is applying for the permit? ~ Owner ^X Opentor <br />Local Contact (familiar with facility): James llendricks Title: Mine Manager <br />Phone Number: (_9701 385-4451 Fax No.: (970) 247-7752 <br />2. Name and Address of Owner: <br />Name: Same as 4bove <br />Mailing Address: _~ <br />City, State and Zip Code: <br />Phone Number: ~) Fax No.: <br />3. Location of the Facility: <br />Street Address:-Ido specific mailing address <br />City, State and Zip Code: Durango, :.a Plata County, Colorado <br />County: l.a Plata Name of facility : *' N' <br />Portions of SecC. 4, T3 ;1, R ;J, .act. .,, ;: , r <br />Legal Location (1•ownship, Range, section, l/4 section): any Sect. 33. T351J, R91d <br />I~titude and Longitude• 37' 15' 00 N, 107' S 1' 20" 1•f <br />4. Corporate Structure: Please provide, on a separate sheet, the corporate structure(s) for those companies listed in items 1 and 2. The <br />sweture should extend to the ultimate parent company. 1n the case of a joint venture, please provide this information for each company <br />which is pan of the joint venture, as well as ownership in[erests. See Attached <br />Standard Industrial Classification (SIC) Code(s) for this facility. (Include up to four, in order of importance.) <br />a) 1291 b) c) d) <br />Coal Minina App. x/96 1 <br />