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INDUSTRIAL 'dASTELJATER ~ISCI'ARGE .4PPLICr.-1N <br />~~ <br />FOR AGENCY USE <br /> <br /> <br />lit Ir v'.1 ;~ <br />i(:II4. ~ Li l.. <br />GATE RFCEIVE^ <br /> <br />YEAR M0. DAY <br />L~ JUL2. 71982 <br />_J <br />WATER OllALITY CCtJ I H0~ <br />Permits Section ' <br />Do not attempt to complete this form before reading the accompanying instructions. <br />PLEASE PRINT OR TYPE <br />1. Name, address, and telephone number of the owner of the facility producing <br />discharge. <br />A. Owner(s) Viking Coal Company <br /> <br />8. Faci 1 i ty name Pryor Strip Mine <br />C. Mailing addresB.O. Box 4 <br />D. City AQUi1ar E. State CO <br />F. county H`~xrfano G. Zip Code 81065 <br />H. Telephone Number ( 303 ) 941-4151 <br />Area Lade <br />2. Is the facility operated other than by the owner? X YES NO <br />If yes, complete the following: <br />Operator to be determined after Colorado Mined Land Reclamation <br />Facility name Findings Document is issued. <br />Mailing Address <br />City State <br />County <br />Zip Code <br />Telephone Number <br />Also, on the back side of this page describe the relationship, agreements and <br />time frame of any agreement. <br />3. Specify whether owner or operator is making application for the permit. <br />Owner <br />a '~ <br />