2011-06-07_PERMIT FILE - M2011029

• Permit No: M2011029
• IBM Index Class Name: PERMIT FILE
• Doc Date: 6/7/2011
• Doc Name: Incompleteness response
• From: Jubilee Venture LLC
• To: DRMS
• Email Name: DMC
• Media Type: D
• Archive: No

6-0-1 Z/T n1- C b )
Water Quality Control Division - Stormwater www.coloradowaterpermits.com
3) *SITE CONTACT local contact for questions relating to the facility & discharge authorized by this permit
for the facility.
0 Same As 1) Permittee
Responsible Position (Title):
Currently Held By (Person):
Telephone No:
email address
Organization:
Mailing Address:
City: State: Zip:
4) OPERATOR in Responsible Charge?N Same As 1) Permittee
Responsible Position (Title):
Currently Held By (Person):
Telephone No:
email address
Organization:
Mailing Address:
City: State: Zip:
Certification Type Certification Number_
5) * BILLING CONTACT if different than the permittee
6)
Responsible Position (Title):
Currently Held By (Person):
Telephone No:
email address
Organization:
Mailing Address:
City: State: Zip:
OTHER CONTACT TYPES (check below) Add pages if necessary:
Responsible Position (Title):
Currently Held By (Person):
Telephone No:
email address
Organization:
Mailing Address:
City: State: Zip:
? Pretreatment Coordinator
? Environmental Contact
0 Biosolids Responsible Party
? Property Owner
? Inspection Facility Contact
? Consultant
? Compliance Contact
? Stormwater MS4 Responsible
Person
? Stormwater Authorized
Representative
? Other
Page 3 of 8 Revised 3/2011
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