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COLORADO WATER QUALITY CONTROL DIVISION NOTICE OF TERMINATION www.coloradowaterpermits.com <br />PART C. FACILITY /PROJECT INFORMATION <br />Facility /Project Name <br />Location (address) ONE Mi LE- SDUTH of" yjALDeM H ICHW AX !J <br />City V JALD.Et\' County T/�CksC `', Zipcode FC"f 80 <br />Local Contact Name <br />Phone <br />Title C=t= f A4 I NC 14 6 <br />Email C— C a— C C)('V) <br />PART D. TERMINATION INFORMATION QUESTIONS <br />Y Please answer the following questions as completely as possible to assist in the approval of this <br />termination request. <br />y Only answer those questions that apply to the specific permit or certification being terminated. Not <br />all questions need to be answered. <br />D.1. FACILITY IS IN OPERATION <br />If Facility is in continued operation respond to only one of the following: <br />1. TERMINATION BASED ON ALTERNATE DISPOSAL OF DISCHARGES. <br />The Discharge is being disposed in another way: <br />a. Solid waste disposal unit e.g. Evaporative Ponds n <br />b. No Exposure — Industrial Stormwater Only NOX Number <br />c. Combined with another Authorized Discharge Permit Number <br />d. Permit is not required : please explain - attach additional pages as needed (includes coverage <br />by low risk policy, etc.) <br />® 2. FACILITY covered by the permit, certification, or authorization listed above IS IN OPERATION, <br />however, the ACTIVITY at the facility producing the discharge covered by the permit has ceased. <br />Page 3 of 5 form last revised March 2010 <br />