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D~ISTRUCTIONS FOR 7'BE COMF'I.6T10N OF AN <br />APPLICA170N FOR AN AIR POLLU170N EMISSION E'ER11fIT <br />The fagowvrg mmustiom for do mssspletioo of the Appliotiaa for Eoscaoo Fermis art tided, kaered, asd sarmbered me ame as r6e apploble seldom of me form m the <br />usher sides If a session does mt apply, arise 'NIA': DO NOT LEAVE BLANK. <br />NOIE All iofor~tioa submNed as past of ms pesmu applodm wad all dm gerteratd by the Division u part of ptoassiag shin permd will be mmidescd open m me <br />mless wsJdeotial trn®eot is requested in writing. All surL smoerials 1111151' be (1) clearly snarlccd 'CONFIDENTIAL' asd (J) emlmed 'm a se soled em <br />maned 'CONFIDENTIAL DiFORMATION' m metre agaimt amidesrsal release. Confideetiality is grantd otdy d the rclose of such ioforsmdcm aoaW result m emoomic <br />deadvannge m the applir+^r V confideasialiry is tequesaM. the Divisba will ratify you of is decision and. if denied, Wow tisrc for you m prrsem arlditioml evidence <br />jusnfymg the orcd for mofidmsiality. In general, mtrfidotialuy regtcm usL vtrxnx permit procosiug time. Under ro cccuaurarrrs m eatmions dun be held mafidmtial. <br />1. PERMIT ISSlkD TO: Ist the tome of the person (e.g., corporation. partnership, ass«ution, individual owrcr, or gpve...,,rnnr agercy) m whom s~ persNt <br />u m be ;.°,ed »d who will dnrcforc be respomrble for the operadoo of the saun:e. <br />l.a. ACFM FOR SERVIC~'• Ttta a fie person or r~rrQany legally raposmble for all permit actiom: this Dann u filed with the Colorado Secretary o! Sot. If there <br />is ro 'Agent for Service,' writ 'N/A.' <br />].b. Fedcnl Tu ID Number u on nYAN with Deparlrrcnt of Revenue. <br />4. GENERAL NATURE OF BUSINESS: 1st do bosom atsviry (ores[ patter. saw mill, fumimrc manufacorrcr, mtmnrcial prmmg, Lire resseading, et J. Also. <br />list the Snsdard Indmaial Classificatan (S.I.C.) Eor this type of bmircss activiry. <br />].a. AIR POLLUTION SOURCE DESCR6r170N: Provide a brief description of the equipmem being permived aM she associated emission mtmols (e.g., coal feed <br />boiler wish 6aghouse, paint booth with particvlan filtra). <br />NOTE: More dun ore Air Pollutant Emission Notice (APEN) may be needed with this application, if there a rmrltiple snorers. ONy ore applinron form needs . <br />m be complemd. <br />b. Lm the muirtwm number of days per ycar that the source will operate. <br />6.a. SOURCE ADDRESS: Do rot give a P.O. Ebx. This Pot the phpial bcation of the source. Please include a rtup which vtdinns the exact location asd shows <br />major topographic fnmrn. If me snorts is portable, ixlude the locatiom and darn where Ure snorts will be opentd during dantian of pcrmir (if known); <br />otherwise. list fiat openung I«ation. <br />V7M coardinatcs are shown on US Genlogtcal Survey (Topo) maps (lot laumde and longitude if lflMs rot known). <br />7.a. ESfINATED COSTS: Snorts - Enrcr ntimated caprnl cost of me rnarc source (ircluding conaol equipmem). <br />b. Au Pollution Conaol Fquipmcm - Entr tic apid and annual openung costs o(dtc control equipment oNy. • <br />B.a In ordcr m loon a source's !nrcnual m emn IPfEI for crinria pollunna. the Regulatson No. ]option taut be chosen. In order for r. rcw source m limit is PTE <br />for Harardous Air Polluunrs !RAPS). the Regulation No. ]muss also be chosen. fbds me Regulation Yo. ] and Regulation No. E. opdom use available for an <br />exuung source m Irmo its PTE for RAPS. Public comnrcnr must be cotducted prior m Ne usuurce o! any emission permit dot Ionia a source's PI'E. <br />B.d. ESiLNATED START-I1P DATE: Thn amsomd dun allows the Dtvuan m anticipat when the requved impectloo for foul appro.~al will be coMucsed. If the <br />projev:t comisa solely of an activiry. e. g., lard development, me darn in vertu gb aM Bd will be the same. NOTE: Opmtion prior m receipt of a permit u <br />prohrbtted by Colorado Snmte. <br />9. APEN FH~C FEE: Pay fI00.f10 fdttg CQ per APFN as this time. Initial and Fwl ADDmval Fcea will be assnsed on an hourly rat during processing wad will <br />be rcqunred by sepant loner. ANNUAL FEES WILL BE BILLED FOR EACN SOURCE REQUDIAIG AN ADEN TO COVER THE COSTS OF <br />PERIODIC DiSPECITONS AND ADIIINISIRATION. Asmral fees are based oo the quarrtity and rYDc of pollunrm courted. For specific inforrmsioo related <br />m feu see AQCC Regulation No. ]. Section VI. <br />t].a. The cost of copying and rturling the amlysu will be charged m Jte applrnnt. Processing delays may «cvr if drerc use qunsiom regarding do analyse. <br />b. Res raw requests wdl usually add m boor pr«nsmg case and ps«wing time. The Division will comder do requnt an official extrann of do processing . <br />dcadlun spsrfad by me Att. The estmion will comiss of she romber of dap ehpsed beweeo Diruion mailing of dse dolt pertnt m do apple,,,. and reaip <br />of do appsian's mrrurterm by On Drvaors. rot m exceed 13 days. However, do Division n ros bouts m minder any mmmenn nxeived after the IS day time <br />pond lafwa, rrrtlcn hods do Divsurr and dse applicant agree m a further eatesssinn of she orocessing dodlirsn. Any addrtioml sine and charges uctrrted by me <br />Drvaton m providing a dolt atd tortesposdtoce wndr do appliran tidl be billed m the applicam. <br />N077CE ONCE AN APPLICATION IS RECEIVED, ALL PROCFSSWC TPME WHL BE CHARGED REGARDLESS OF WFIETI[ER A PERPD'T 6 ISSl1FJ) <br />OR NOT. ff A PROJECT R CANCELLED, THE DIVISION SHOULD BE NOTIFD7) IN WRITIIiC L1fAtEDIATELY. SPATE: LAW REQUDIFS TEAT <br />EMLUION PFILJDiS MAY NOT BE ISSIhD UNTD. FROCESSDVC FEES ARE PAID. PROCESSING FEES ARE BASED ON THE AMOUNT OF TIME SPENT <br />REV(EH'INC THE APPLICATION A.W ISSUING THE PERA4f. <br />'Ead~on Przdl" stuns the name n'Cmssructbo Pamh" as rcgrdred under Pan B of Regulaslua No. 7, v n e>dsn aner JWy 1, 1992 wad b the permB required <br />order aecllao ZS7-112, C.R.S., aner July 1, 1992. <br />• <br />