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r~o~ iii 41 ia:as [~! FFORG:?,l•wLDECK 15SIOti PERniT OR ' 'RM17 nODiF1LATlON P•?%13 <br />AYYLI:.A71UM run rv~i~~.+.• ~.~ <br />'iris aoplic~ation muse De filler ou ompletely except for 1'1 L .l [ner..ise, application <br />.:T3 Ds considered inCCmplete - SEE INSTRUCTIONS ON REVERSE SIDE. -+al} completed applitstlon, <br />'~P£NS. and filing fee to; Stationary Sources Program, Air Pollution Control Division, <br />~iorsdo Deoartment of Health_ 4210 East Ilth Avenue_ Denver. falarada BD220_ (371'i/ 977_ASyFI <br />PERMIT TO <br />set Mining <br />P.0. Box 535 Somerset, CO <br />State: 81434 <br />IIP COOE: <br />on <br />W. A, Bear, Sr. <br />QE C 1 Q 199J <br />~s. GENERAL NATURE OF BUSINESS: b. SIC Code: <br /> Coal Mining C~.. ~ °~ "i°~ <br /> CenuM.Y! tlMaaf .. <br />ia. AIR POLL ION SDURLE DESCRiP~ION: CMECK~IF EQUID. 15 PORTABLE Q 5b. Days per year <br /> Conveyors, haul roads, truck dump, tipple, silo source will operate <br /> 235 <br />sa. SOURLE LOCH lON AODR SS: Check i map included: xx 6. UTM Coordinates <br /> <br />` (in lun) <br /> Somerset, CO C NTy Gunnison <br />~ H <br />_Y <br /> _ _ _ _ <br />_ _ <br />w <br />~. ESTIMATED LOSTS: Air Pollution Control Procatlures or <br />Equipment: <br />~a. Sourea, Process Equipment or Project: 7b. Capital Cost:$ existing Annuallzed:S <br /> Lap, Facility is existingq <br />Lost:S Mnualized:S <br />7c. Operating Lost S 32,000 /yr,~- <br />~. STATUS <br /> ^ New Ait Pollution Source <br /> ^ Existing Source Change (Control equipment added, process change, etc.): <br /> ® Other:Grandfathered Source, New Owner <br /> Projeetad.Dates for Construction to: Projected Souree Startup Date: <br /> 8b. B.oin: 8e. End: 8d. ~xisting Facility <br />g. Enclose cheek to cover APEN FILING FEES. One APEN should be filed for eaeh emission point: <br /> one APENs E $40.00 per APEN S 540.00 <br />I4. SIGNATURE OF LEGALLY AUTHORi2ED PER ON NOT vendor ila. DATE SIGNED: lib. TELEPHONE NO.: <br />or quipmeni manufac rer): <br />/l/t (v/9D t303} ~9-5775 <br />\ ~ll~.~y~ .w ~ . <br />12. Type or print name and of icia title of person signing item 10. Only <br /> <br />k'. A. Bear, Sr., Agent ~pU.~D <br />~ <br />j. Check appropriate box if you want: ~0 V 2 <br /> a. ^ Lopy of preliminary analysis conducted by Division ~~ <br /> b. [] To review a draft of the permit prior to issuancel AIR PQ LU71 +r <br /> N07E: Lnecking either item Could result in increased fees $7AT1 AMY $(~C~nC <br /> <br />or processing time. See Reverse. GRpM <br />,:.PLD:55P: {Rev. 11/87 - 1214f) <br />note 2ooc <br />~ r rl <br />