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~_ ,~ <br /> <br />-3- <br />"iOTICE PROCEDURES <br />• <br />After the application has been filed with the Division, notice pro- <br />cedures outlined in Section 3.2 or 4.2 (whichever is applicable) must be <br />followed. <br />ADDITIONAL I2iFORPfATIO;i <br />This space can be referenced for further information of any of the items <br />on this form. <br />To the best of my knowledge, all the infomation presented ie this application <br />is true and correct. <br />\~.,~~~iru i~n~,y. <br />'-vim:` ~ NUMBER '•. 5/= <br />_~ 10428 .?_ <br />~O J <br />Q <br />.` P~'~fSS\~~ <br />J'l'''• :FH6INEE?: ~ ~ p~ <br />%9jF oF..C0~0~p~`. <br />~~~~ninn\\\`` <br />(Signed by individual legally authorized <br />to bind the operator to t;iis application) <br />Prepared by: <br />R. ephen Schermerhorn, P.E. <br />President <br />Impact Environmental Consultants <br />• <br />