2011-05-19_PERMIT FILE - M2011026

• Permit No: M2011026
• IBM Index Class Name: PERMIT FILE
• Doc Date: 5/19/2011
• Doc Name: Additional application materials
• From: SME Environmental, Inc.
• To: DRMS
• Email Name: KAP
• Media Type: D
• Archive: No

APPLICATION for DISCHARGES ASSOCIATED WITH SAND & GRAVEL MINING AND PROCESSING
1. CONTACT INFORMATION (continued
Local Facility Contact ? Same as Applicant ? Local Contact should receive Discharge Monitoring Reports (DMR's)
Local Contact Person: First Name: Keefer Last Name: Rader
Title: Project Manager
Phone: [phone]
Email Address: [e-mail]
DMR Contact D Same as Applicant ? Same as Local Contact Company Name
DMR Contact Person: First Name: Last Name:

Title:
Mailing Address:

City State Zip Code

Phone:
Email Address:
Billing Contact D Same as Applicant Company Name
Billing Contact Person: First Name: Last Name:

Title:
Mailing Address:

City State Zip Code

Phone:
Email Address:
2. PERMITTED FACILITY INFORMATION
Type of Facility D New (beginning operations after 10/1/1992) ? Existing (as of 10/1/1992)
Name of Facility Keyah Grande Gravel Pit
Location of Facility
Street Address (or cross streets): 13211 W Highway 160
City (if unincorporated, so indicate): Pagosa Springs County: Archuleta
State and Zip Code: Colorado, 81147
Latitude and Longitude (approximate center of facility to nearest 15 seconds, using one of following formats and NAD 83 coord. system):
Latitude: 37 1 3 00 Longitude: 107 14 15 (e.g., 39°42'11", 104°55'57")
degrees /minutes/ seconds degrees/ minutes/ seconds
OR
Latitude:
Longitude:
degrees (to 3 decimal places) degrees (to 3 decimal places)
(e.g., 39.703°, 104.933')
3. STANDARD INDUSTRIAL CLASSIFICATION (SIC) CODE(S) FOR THIS FACILITY
(See Appendix A - include up to 4 in order of importance).
a 1442 b 1446 c 1422 d 1423
4. DESCRIBE THE INDUSTRIAL ACTIVITIES WHICH TAKE PLACE ON THIS SITE
Excavation of sand and gravel as well as crushing of material on site.
Page 2 of 5 Revised 12/2009