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PROCESS WATER AND STORMWATER <br />DISCHARGES ASSOCIATED WITH <br />SAND AND GRAVEL PRODUCTION <br />OPERATIONS (AND OTHER <br />NONMETALLIC MINERALS <br />EXCEPT FUEL) <br />Please print or type. Do not attempt to complete this form before reading the instructions. <br />New or Renewal XX If renewal, existing permit number: CO G- 0500470 <br />1. Name and address of permit applicant: <br />Company Name: Ready Mixed Concrete Company dba Ready Mixed Aggregates, Inc. <br />Federal Taxpayer (or Employer) ID #: 84- 0360534 <br />Mailing Address: 14585 Old Brighton Road <br />City, State and Zip Code: Brighton, CO 80601 <br />Phone Number: (303) 659 -0630 <br />Local Contact (familiar with facility): Mr. Nathan Merkison <br />Phone Number: (303) 659 -0630 <br />Who is applying for the permit? XX Owner XX Operator <br />2. Name and address of property owner: <br />Name: Ready Mixed Concrete Company <br />Mailing Address: 4395 Washington Street <br />City, State and Zip Code: Denver, CO 80216 <br />City, State and Zip Code: Brighton, CO 80601 <br />County: Adams Name of facility: Erner's Pond Pit <br />Latitude and Longitude: 039 °, 58', 47" N; 104 °, 50', 20 "W <br />Title: Plant Manager <br />Fax No.: (303) 659 -7353 <br />Phone Number: (303) 292 -1771 Fax No.: (303) 295 -0470 <br />3. Location of the facility: <br />Street Address: N/A <br />FOR AGENCY USE ONLY <br />PERMIT NUMBER <br />C <br />0 <br />DATE RECEIVED <br />YEAR <br />MONTH <br />DAY <br />TYPE: <br />P <br />lq r -o3 <br />Legal Location (Township, Range, section, 1/4 section): T 1 S; R67W; S12; parts of NE, NW, SW and SE 1/4 — sections. <br />S <br />