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A. Stormwater vs. Process Water <br />fM you discharge any of the following ptstcas gettetateJ wastewaters from your facility, to state waters? <br />u XNo~ Yes Product wash waters <br />aXNoa Yes Main[enaocdcyuipment wash waters <br />a X No Yes Tsansport waters (e.g., slurries) <br />•XNoa Vex Sruubbtr waters (crushers or classiliers) <br />a Nox Yes Mine dewffiering (groundwffier and/m runotTfiortt the mine) <br />If you answered YES to any of these questions, continue on to Item 9. <br />If you answered NO to all of these questions, skip to Item 18. <br />9. I.oeatioo map: A location map designating the facility property, discharge points and receiving waters shall be submilled. Thc map shall6e from <br />a 72 or IS minute USGS sryad sheet, or a map of compambk scale. A north arrow shall be shown. The map must he on paper 8 2 x I1 inches. <br />10. Site Sketch: A legible grneral sketds of the site shall be submitted, showing appurtenant facilities {buildings, ponds, diversion ditches, stockpiles, <br />eteJ, stream location, numbered discharge points, sampling and Ilow monitoring points. The map must be on paper 8 2 x 11 ioches. The <br />omfalls shall 6e labeled to correspond wiN Ne numbers listed in I5. <br />11. Site-specific conditions: <br />a) Does this (acilily have bulk storage of diesel fuel, gasoline. snlvrnte, fertilizer. <br />ar other hazardous materials on site'? ~ XNo ~ Yes <br />h) Is This operation located within one mile of a IandGll, or any mine or mill tailings? aX No u Yes <br />c) Does the dewatering area have or posnbly have gnruodsrater contamination, such as <br />Plumes from leaking undergound smrage tanks, eu:.? aX No u Yes <br />If~S Cm any of These, please show location of the landfill, tailings ur possible groundwater amtamma[ien on the location map in item 8 or in the <br />general sketch in item 10. Plvasc explain the location, extent of contamination, and possible effect on the discharges from this facility. <br /> <br />