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GENERAL PERMIT APPLICATION <br />STORMWATER DISCHARGES <br />ASSOCIATED WITH: <br />CONSTRUCTION ACTIVITY <br />(Permit No. COR- 030000) <br />5/95 /const <br />• <br />Please print or type. All items must be completed accurately and in their entirety or the application will be deemed incomplete <br />and processing of the permit will not begin until all information is received. Please refer to the instructions for information about <br />the required items. An original signature of the applicant is required. <br />1. Name and address of the permit applicant: <br />Company Name: AmerAlia, Inc. <br />Mailing Address: P.O. Box 1330, 818 Taughenbaugh Blvd. <br />City, State and Zip Code: Rifle, CO 81650 <br />Phone Number f 970) 625 -9134 Who is applying? Owner XX Developer ^' Contractor ^' Federal <br />Taxpayer (or Employer) ID#: 87- 0403973 <br />Entity Type: Private XX Federal ^' = State ^' County ^' City ^' Other: <br />Local Contact (familiar with facility) : Roger Day <br />Title: Vice President, Operations Phone Number: (970) 625 -9134 == <br />2. Location of the construction site: <br />Street Address: about 9800 Rio Blanco County Road 24 — (address assignment pending from County) _. <br />City, State and Zip Code: Meeker CO 81641 <br />County: Rio Blanco Name of plan or development: NA <br />For Agentlse Only <br />COR -03 <br />Date Received <br />Year Month Day <br />Legal Location (Township, Range, section, 1/4 section): NW 1 /4 of section 20; T1S, R98W <br />Latitude and Longitude: about 39 °57'15" North latitude and 108°25'15" East Longitude <br />3. Briefly describe the nature of the construction activity: <br />Construct facilities for nahcolite (sodium bicarbonate) solution mine. Facilities include access road, plant building; pipeline, <br />production well field, fresh water pond, holding tanks, drain -down pond, and monitoring wells. All facilitiescare under <br />jurisdictions of the US Bureau of Land Management and the Colorado Division of Minerals and Geology.:a 1 <br />