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AIR POLLUTION CONTROL DIVISION - COLORADO DEPARTMENT OF HEALTH <br />4210 E. 11th Avenue. Denver, Colorado 80220 - Phone: 320-4180 <br />APPLICATION FOR EMISSION PERMIT <br />T application shall be filled out completely - see instructions on reverse side. <br />1. PERMIT TO BE ISSUED T0: Telephone No. (801) 534-3470 <br /> Western S1 Carbon, Inc. <br />2. MAILING ADDRESS (include zip code): <br /> P.O. Box 1526 - 315 East 2nd South - Salt Iake City, Utah 84110 <br />3. TYPE OF ORGANIZATION: <br /> Y~Corporation partnership L~Individual Owner L/Governmental Agency <br />4. AGENT FOR SERVICE: Tan Muncy, Superintendent Catherine V. Chachas <br />Environmental Engineer <br />' <br /> s Nest Mine or <br />Hawk <br />Western Slope Carbon, Inc. <br /> r Colorado 81434 <br />5. GENERAL NATURE OF BUSINESS: Salt Lake City, Utah 84110 <br /> Underground Coal Mining <br />6. AIR POLLUTIOW SOURCE: Pursuant to Regulation No. 3 of the Colorado Air Quality <br /> Hawk's Nest East Mine Control Commission, application is hereby made for an <br /> Emission Permit for the following air ollution source <br /> (attach separate sheet where necessary <br />(crushing facility, conveyor and transfer) <br />7. SOURCE LOCATION ADDRESS: <br /> 2 miles east of Sarerset, Colorado COUNTY(IES): Gunnison <br />8. ESTIMATED COST OF SOURCE OR MODIFICATIONS: Process <br /> Air Pollution Control Equipment none Equipment <br /> Days Per Year Source Will Be Operate ~sn <br />9. STATUS (check and complete applicable items): <br /> ~/New Air Pollutant Source Estimated Date Estimated Date <br /> L~Control Equipment Being Construction Construction <br /> Added to Existing Source Will Begin Will Be Completed <br /> /x jActivity Change Operating <br />10. Check is enclosed to cover APPLICATION FILING FEE /~~ $40.00 <br /> (see No. 10 on reverse side of this form) <br />11. ANTICIPATED START-UP DATE I 12. DATE OF APPLICATION <br /> October 1, 1980 <br />13. SIGNATURE OF LEGALLY AUTHORIZED PERSON <br /> <br /> <br />14. Type or print name and official title of person signing this application. <br /> Catherine V. Chachas - Environmental Engineer <br />Date Received 15. REMARKS: <br />APCDLOOC (RtV. 3/80) <br />