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Permit Name <br />Yes <br />No <br />Applied For, Date <br />Permit No. <br />a.) Colorado Division of Minerals and Geology <br />(formerly MLRD) <br />XX <br />May 30, 2003 (approved) <br />M 2001 - 046 <br />b.) Underground Injection Control <br />XX <br />c.) Dredge or fill permit under Section 404 of the Clean <br />Water Act (CWA) (Army Corps of Engineers) <br />XX <br />d.) Resource Conservation and Recovery Act (RCRA) <br />XX <br />e.) CDPS Stormwater <br />XX <br />COG - 500425 <br />f.) Colorado State Air Pollution Emission <br />XX <br />Unknown <br />04WE1046 <br />g.) Other <br />II <br />4. Standard Industrial Classification (SIC) Code(s) for this facility. (Include up to four. in order of importance. See Appendix A.) <br />a) 1440 b) 1442 c) d) <br />5. Receiving Stream: The name of the receiving stream(s) (If discharge is to a ditch or storm sewer, also include the name of the ultimate receiving <br />waters.) Saint Vrain Creek via on - site ditch owned by the operator. <br />6. Industrial Activity: Describe the primary industrial activities which take place on site (e.g., sand and gravel mining, gypsum mining, sand <br />washing, gravel crushing, stationary or mobile asphalt/concrete batch plants, etc.). Indicate the status of the facility (active, inactive, being <br />reclaimed, etc.) Sand and eravel mining; convey n -site processing including crushing, screening and washing and <br />stacking for off -site hauling. <br />7. Other environmental Permits: Does this facility currently have any other environmental permits, or is it subject to regulation, under either of the <br />following programs? <br />If Yes to item 7.a), please include Colorado Division of Minerals and Geology (Mined Land Reclamation Board) permit anniversary date: <br />30 May of each year. <br />9 <br />