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Colorado Department of Public Health and Environment <br />Air Pollution Control Division <br />- MINING OPERATIONS - <br />N. SITE DISTURBANCE <br />Total Area of Site: 62 Acres <br />Total Disturbed Area of Site: 40 Acres <br />Proposed Controls: <br />Watering <br />? Frequent (Watering Frequency of 2 or More Times Per Day) <br />X As Needed <br />? Chemical Stabilizer <br />Page 7 of 6 <br />? Revegetation Revegetation Must Occur Within One Year Of Site Disturbance <br />? Seeding With Mulch <br />? Seeding Without Mulch <br />x Other (specify) Excavation footprints will <br />be water storage structures <br />Additional Sources of Emissions <br />List any other sources of emissions and related controls (includes fugitive emissions) <br />N/A <br /> <br />-12-11 <br />Signature of Legally Authorized Person (not a vendor or consultant) Date <br />Owner, 4B Land & Livestock <br />Scott R. Brennise LLC <br />Name (please print) Title <br />Check the appropriate box if you want: <br />? Copy of Preliminary Analysis conducted by the Division <br />? To review a draft of the permit prior to issuance <br />(Checking any of these boxes may result in an increased fee and/or processing time) <br />This. notice is valid for five (5) years unless a significant change is made, such as an increased production, new equipment, change <br />in fuel type, etc. A revised APEN shall be filed no less than 30 days prior to the expiration date of this APEN form. <br />Send this form along with $119.96 to: Colorado Department of Public Health and Environment <br />Telephone: (303) 692-3150 Air Pollution Control Division <br />APCD-SS-Bl <br />4300 Cherry Creek Drive South <br />Denver, CO 80246-1530 <br />Revised September 2004 http://www.cdphe.state.co.us/V/stationgy.html