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] PAGE 2 <br />~~ 3. Will the pertninee continue to have a dixhuge poim, such u pipe, ^ Yes ^ No <br />~~ conduit, unlined lagoon, etc? <br />a. Under what condi[iom could a dischuge occur: Storm t1aw, change is operation, <br />~ accidental spill, etc. <br />S. [f [his is a raining facility or operation, indicate whether nay mine <br />drainage exisn. Discuu whether there ha been a hutorical flaw. <br />-, J . <br />6. Is there a dowttaveam water user, weer supply intalm, etc.? ^ Yes ^R No <br />~~ a. [f yes, whom anti where? <br />b. Could they be imputed by a discharge or a sal of ^ Ya ®No <br />nay pollutant oa-site convollable under m SPCC Plea <br />or other condition of a permit? <br />_T~ <br />NOTE: IHE FOLLOWING SROULD BE I~PT IIY MIND iF YOUR PERMIT [S TERMINATED: <br />s-~ 1. The pertniaee will still be «spomible and subjett m a~ en[oteemeat utioa [or nay discharge or spills into state waten. <br />Should you operate your heiliry after your permit ha bees terminated and a duchuge could near, you must apply for a new <br />permit ao less than l80 days prior [o the dixhuge. [t is ttdawfiil m dischuge pollutants from a poim source ro state waters <br />without a permit. Sec[ioa 23-8-608 of the Water Quality Cool Aet provides for assessing civil penalties of up to 510,000 <br />~ per day for ttalawful dischuga. <br />,~ <br />~ 2. Ia general the continued existettee of a discharge point will be the base for not termiauiag a pertait u the requeu of the <br />ll permittee. <br />J~ <br />I certify under penalty of law thu I have penoaally examined and am familiar with the information submitted herein and based oa <br />- ~ my inquiry of thou individuals immediuely responsible for obtaining the iaformatioa. I am awue that there ue significant <br />peaaltied for submiaiag false iaformatioa including the pwsibiliry o[ fine and imprisoamem. See 18 U.S.C, 1001 and 33•U.S.C. <br />1319. <br />1 ,~ ~- 9 ro <br />Authorized ReDreseata a am <br />a <br />1~ <br />Based upon my verificuion of the above information obtained dttring my site ittspeedon, it is my recommenda[ioa that this permit <br />be terminated. <br />" Duvict Engineer <br />' -~ ^ Yes ^ No <br />~__ <br />1 <br />Date <br />