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t , <br /> - Does this tiny c rmt,bm=y odher eawo mew Pumas,or is it subject too regalat:on,tender <br /> p ' <br /> Other FT�n <br /> of the fnllowinBgrams7 <br /> Yes No D=Applied Fin Przmin No. <br /> Permit Name ` <br /> « X ! <br /> CO Div. of bfiac <br /> rals & Geology (formerly MI..RD) <br /> Dredge or fill pc.-ma under Sc-aon 404 of the Clean <br /> Rea Act(-WA) (Artt:Y Cotes°f Ln'tncas) X COR- 040023 <br /> :} CD?S StOrtuv amr" f <br /> other-(list) 1 <br /> hoa Board Permit anniversaz9 data Permit revoked 8/92 <br /> 14a), please include M'�Land Rrdama a liable. <br /> 1f y=to item l with items V and 3g, PP <br /> * If Yrs�°to item 14.�, Ply read and comp Y <br /> S-tte-sPmcir= Conditions: <br /> within one m�of a landfill, or any mine or mill tailings from a historic,site? Noy No Yes <br /> a) Is this operation locatedwater �such as Plumes from lealciag andergo�storage tanks, <br /> b) is sham acmal or suspected 8 d tion oa the l�n map in Item 11 or <br /> of these, please show location of the landfill,t or 1r°=dwats mntam a Ewes this faa''y!- <br /> Zf Yes for any ezt�of eaten and pvssz'bk effect as the d'zsrizsrges <br /> to item 12. Please exPlatn the <br /> the site sktich� roarer or otherwise be is� <br /> floc.'ttlantslsetding agents or other chemical additives be used to trees oa if not <br /> chemical,`re3irzxnh WiIl nary Dats Sbeet(MSDS) with the app�h <br /> i- � Q an$include the)Material Safetp <br /> Yes If Yes,list here <br /> disc e? No data. Use additional sheets if aec==q' <br /> previously sub tied. MSDS should include aquatic t®dt7 <br /> C e r A42nufaetmeer pantose <br /> In white wash Stre2-?• <br /> N/A <br /> ddrad pbw==bw QC 7�of dx II�Sitl�c +:m LC�ttt. <br /> �nr:aaiz a==-Own a cmfidcadd.i dx ffinafas":r s e tine r �or�ccve i dimsis),it L <br /> tprom� or ma=Qs dun st=to"ca product uses or mattufi�e <br /> ed Or-- : The applicant m=provide a List of nay toxic products whirr the applicant cl=ent}y <br /> 7 UsCA or Manufac or ture product or byproduct. <br /> as an,tntc'medtata <br /> None <br /> anal be used°or each d'tsch r Pow(e.g..v notch weir,p�P a��' L-""In <br /> �ment: What method of flow tneasutmmeat ld� the mi�um and maztauun now �� <br /> 18. �l�r�ignm whether currcndy installed or proposed- <br /> last date calibrstad. <br /> Parshall flumes installed <br /> Pro and proms final wmnpli�e daces if subject <br /> a of any ahatem� ffi�-abg or apt P o�f warm tr==teat scot- Lest any <br /> 19. IImpru �amplianG soles for coustm=cn,to any present rq====or ttpgradmS or opc�a <br /> 6=ges from Pn4xm PamuL <br /> None . <br /> If lyn,please proytde a capY of <br /> Is or roll land aBpiicanon of any vr=cv arrr be P N Pinclude a �vgy of the DMG apPrOr �eD <br /> ^�. hand ApPb � of 1•ftnerals and Geology on the <br /> the M= . rah <br /> applicable. Br tY ,. 4- ' <br /> Possible use of tunnel d ' s <br /> a r <br /> of vegetated areas in connection w/ reclamation. <br /> 3 <br />