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GENERAL49820
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Entry Properties
Last modified
8/24/2016 8:29:30 PM
Creation date
11/23/2007 5:26:30 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981017
IBM Index Class Name
General Documents
Doc Date
5/16/2006
Doc Name
Metal Mining Stormwater Discharge Permit-Reappliction
From
Stormwater Permit Folder
Permit Index Doc Type
Reclamation Project
Media Type
D
Archive
No
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COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT May 12, 2006 <br />Water Quality Control Division <br />WQCD-P-B2 <br />4300 Cherry Creek Drive South <br />Denver, CO 80246-1530 <br />METAL MINING STORMWATER DISCHARGE PERMIT <br />REAPPLICATION & RECORD VERIFICATION FORM <br />Colorado Div. of Minerals Ss Geology, Coal Basin Reclaim. Cons. Projects <br />This form is for reapplication for the Coal Basin Reclaim. Cons. Projects facility (COR-040204) under the Metal Mining <br />Stormwater Discharge Permit. By filling out and signing this form and returning it to the address at the top, you will have <br />reapplied. In order to reapply by this simplified method, and to avoid a gap in coverage for your facility, you must return this <br />form by June 30, 2006. Do not send any money with this form -the billing process is handled separately. <br />rvtore mtormatton about ttus nrocess is contamea m me cover letter and ULSiA that <br />**RETAIN A COPY OF THIS FORM FOR YOUR RECORDS** <br />To assist us in improving communication with our permittees, please provide the following email addresses for the following <br />contacts, if available: <br />A. Email of Legally Responsible Person (item 3, below) - <br />PLEASE PROVIDE EhLV L ADDRESS HERE <br />B . Email of Local Contact (item 12, below) - <br />...._...... _.____ ___.__.. .............. .. PLEASE PROVIDE EM1WLADORESS HERE <br />This is the latest information that we have in our records for your jaciltty. Please review the information carefully and make <br />whatever changes are necessary, by crossing out the incorrect information and writing in the new, and sign the form below. <br />Permittee information, including name ojlegally responsible person who is signing this form: <br />1. Pemuttee -Colorado Div. of Minerals Ss Geology <br />2. Federal Taxpayer ID Number - 840644739 <br />3. Legally Responsible Person -David L. Buckram, Program Supervisor <br />4. Phone - 303/866-3567 <br />5. Mailing Address - 1313 Sherman Street , <br />.. Room~215 ~ . <br /> Denver, CO 80203 <br />Name, location and description ojindustrial activity for permitted facility: <br />6. Facility Name -Coal Basin Reclaim. Cons. Projects <br />7. Facility Address/Location - Ead of Coal Creek Road <br /> Redstone, CO 81623- <br />8. Facility County - Pitkin <br />9.Latirude - 39/11/55 Longitude - 107/18/02 <br />Mine Status should be one of the following categories, "Active, less than 10 acres'; "Active, IO acres or more", or "Inactive mine". <br />Inactive mines are mines that are no longer being actively mined Mines that are in temporary cessation are considered active. Ij <br />the status has changed from what is wriKen below, please indicate which one of the three categories is appropriate for the facility. <br />10. Mine Starus - Active, less than 10 acres <br />11. Description of Activities <br />revegetation. <br />Local contact familiar with the site: <br />12. Local Contact <br />13. Local Contact Phone <br />Stormwater Discharges to: <br />14. Receiving Stream(s) <br />-Earth moving, stream channel reconstruction, topsoil application, <br />Steven Reaaer, Project Manager <br />970/241-0336 <br />Dutch Creek tributary to Coal Creek <br />15. To complete this Reapplication, the Legally Responsible Person named above must sign the following certification: <br />I certify under penalty of law that I have personally examined and am familiar with the information submitted on this form and that I <br />believe that the information is true, accurate and complete. Further, /understand that by completing and returning this form, I have <br />applied for coverage under the revised general permit for Stormwater Discharges Associated with Metal Mining Operations And <br />Mine-Waste Remediation (COR-040000) and certified that an up-to-date Stormwater Management Plan is maintained for my facility. <br />Signature of Legally Responsible Person Printed Name Date Signed <br />
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