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ENERAL PERMIT APPLICATION.,_, •-.._.. ,.... . <br />STORMWATER DISCHARGES . - - . ,- <br />ASSOCIATED WITH: <br />LIGHT INDUSTRIAL ACTIVITY ~f ~f ~, 1,41u9 <br />(Permit No. COR-010000) <br />HEAVY INDUSTRIAL ACTIVITY, :,~L:y~ ar.tlf+,6 c`,N.o ; <br />(Permit No. COR-020000) ~i_ <br />METAL MININ `'~ ~ 'q <br />r~ <br />t .,:L AGENCY USE ONLY ~ <br />Certification Number <br />C O R - 0 Q ~[ <br />Date Received Fee Ca[egory <br /> <br />Yeaz Month Day <br />G (Perm[[ No. COR-040000) ,,1,3c,' <br />Please print or type. Do not attempt to complete this form before reading the ins[ructions. <br />1. Name and address of permit applicant: <br />Company Name: _GOLDEN WONDER MTNTN T.T. <br />Federal Taxpayer (or Employer) IDN: 8 4_ 1 2 7 6 6 5 2 <br />Mailing Address: P - O - ROX X68 <br />City, State and Zip Code: LAKE CITY, COLORADO 81235 <br />Phone Number: ( 303 1 639-3133 Who is applying for the permit? ^ Owner ®Operator <br />Local Contact (familiaz with facility): vFUx r,r LARRY VICKERS <br />Title: FORMER OWNER FAMILY Phone Number: ( a70 ) 944-2249 <br />2. Location of the facility: <br />Street Address: NONE <br />Ciry, Slate and Zip Code: LAKE CITY. COLORADO A1735 <br />County: HINSDALE Name of facility: GOT,DEN WONDER MTNF <br />~_ <br />Legal Location (Township, Range, section, 1/4 section): iuF~ cFr t n & NW% CRC. t 1 T-44N. R.4i, <br />Latitude and Longitude: 'IR° On' T 5" N~ t n7° 1 A' S ~" w <br />Type of Facility: ^ New (beginning operations after 10/1/92) ®Existing (as of 10/1/92) <br />3. Standard Industrial Classification (SIC) Code(s) for this facility. (Include up to four, in order of importance.) <br />a) 10~ b) 33~`, ` c) d) <br />4. Permit Category: Under which stormwa[er general permit does this facility belong? (See Appendix A.) <br />^ Heary Industry ^ Light Industry ~ Metal Mining (or Coal -see Instructions) <br />Mines only: MLRB permit anniversary date Oct . 1 Which category is your facility under? <br />® Active mine, less than 10 acres ^ Active mine, 10 acres or more ^ Inactive mine <br />5. Receiving Stream: The [tame of the receiving stream(s). (If discharge is to a ditch or storm sewer, also include the <br />name of the ultimate receiving waters). Deadman Gulch (intermittent). then Lake Fork of <br />Gunnison River <br />7/96/Uvn -1- <br />