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f ' -- <br /> perttt+ Does tiffs beTKY�late=Y abet=YiimmenrsI Pam .�is i[9nbjeCi to ct�4 tmdar <br /> Other <br /> of the fallo-ing PTOVasns? <br /> yes Ko <br /> Data Applied For P-smic No. <br /> Nam <br /> X <br /> CO Div. of 3,f=r31-3 & Geology(formerty MIRD)' I <br /> Dredge or fin der Se^^oa 404 of the Clean <br /> D ; <br /> wale: Am (CWA) (A MY Corps of%n;incas) I COR- 04 0 0 2 3 t <br /> I J <br /> :) CDFS Smrmwa2:r•` <br /> Other anniversary Permit revoked S/9 2 <br /> include Mined Land Reeiamatioa Board pit ble. <br /> If Yes to item 14.$), Please with it,= 37 and 38, as appr= <br /> It yeses_to it-m 14.f), please read and comply <br /> Site-sPe� Conditions' <br /> or=M tai ,,s from a historic site? No LJ etc.,) No E Yes <br /> El <br /> a) IS this oP <br /> cranou Iocat:d w� �� of a� 1ia l�� j�from leal6ug under�d storage tanks, <br /> b) Is there anal or sssPu� 11 or <br /> jorstioa of the landfiII, ta�ss or gzocadwater a°ntaawtsttoa as the lxation fP is item <br /> If Yes for an7 of that P e=lain the kc�ou of wataasi <br /> mfion and p�ble effect on the dis�sr�Erona this Eaa3Ytl'- <br /> tje J�skech in he= L?- w=or Otherwts-be m the <br /> floc:ulants/setsimg agesus or otiser chtmical additives be used m L'� <br /> . C>z�l,fitment_ VFM any S)with the application if not <br /> Qand i.&,de the Material Safety Data Sheet(MS'D <br /> If Yes,hst here <br /> d""u:hzrgt' No yes sheets if net=scary <br /> Fx ct'o <br /> ��ed. ?yIS'DS should include aquatic t033 t data. Use additiotsal <br /> �Which Waste StrraIIs?. <br /> Igame . M=ufact= Pnroose <br /> N/A I <br /> Ss aaC phone aim Ice or a� <br /> "'s Same,earsaec Pam°• e�or=an i Wtdk=% )-if twwn <br /> :.�c^ '�►°crmuh s uakrawn at 1 �. please Tat the aapr cam <br /> �C Ubel isu�'-=or........,:<handlioq daa s�fix exh pti°dues LLSCS of inanllfas <br /> • The a Kenai trntas provide a Iist of nay to <br /> c products which the applicant currently <br /> 7 T sect or Manufactured Taxi s. PP <br /> as as int--medi=or final product or byproduct. <br /> None <br /> cat wt11 be tucd for eats d"tscharge point (�•g <br /> v notch war.P=p l'Pam the <br /> eMta RThat method of flow mcasut�; the mum and maxuttum tow mr m� <br /> :8. FkrW M Whether carrct>uy Wstalled or prpposc:?- <br /> tzm ccc.). Designate <br /> last date caltbrsted.. 1 , <br /> Parsha11 flumes installed <br /> and projected final compliance ¢subject <br /> description of airy lbas�t r Qui �' - or p aJ a waste u�eatmemt a eac j:ut nay <br /> 19. Lu � Ir"ore arp -Sc•t`files for conswa= n. i mg ° <br /> rhatt�f 1cm prevx=PI <br /> None . <br /> If Y -,de pk�u PrQ9 a copy of <br /> be No El Yes ®of the DMC* aPPrO°al where <br /> Is or w31 land saplication of any waszev;= onP!the and inc'. <br /> ,0. d App ip sssbt to the Div�iaa of W. meS� and Geob$T <br /> app$able. Brirf:Y dI e dy-' pttxess: }; <br /> Possible use of tunnel d ' s <br /> r a a ar -F. <br /> � o <br /> connection w/ reclamation . <br /> of vegetated areas in <br /> 3 <br />