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RECYCLING FACILITY ANNUAL REPORTING FORM — CALENDAR YEAR 2011 <br />Facility Name: Broda's Inert Fill - Aggregate Industries Platte Valley Pit <br />Telephone: 303- 808 -2500 Count,. Weld <br />Estimated Number of New Recycling Jobs- five <br />Submitted By: Pat Broda Date: 04/26/2012 <br />Material: AGGREGATES Unit of Measure (required): Cubic Yards <br />Include such items as concrete, asphalt and other recycled road building materials. <br />1. INVENTORY <br />Inventory at Total Amount Total Used by Total Sent Offsite Inventory at <br />Beginning of Year' Received Facility Onsite (3a + 3b) End of Year <br />(2a + 2b + 2c) <br />a 0 b 46,875 c 41,875 d 5,000 <br />' Inventory at beginning of calendar year 2011 should equal inventory at end of calendar year 2010 <br />2. AMOUNT RECEIVED (Be as specific as possible) <br />(la +lb) - (lc +ld) <br />0 <br />Material sent off site was crushed asphalt from the asphalt and asphalt fragments removed from loads received at the <br />facility. The material used by the facility was placed into the pit according to the DRMS mining permit for the Aggregate <br />Ind. site. <br />If you would like confirmation of receipt of your form, provide your email address: molenassoeiates@gmail.eom <br />Due May 1, 2012 <br />Source <br />(List approximate QUANTITY from each) <br />Source Name City/County <br />State <br />Residential Commercial Mixed <br />Adams County Highway Dept Commerce City <br />CO <br />4,200 <br />Norra Concrete Keensburg <br />CO <br />4,500 <br />Concrete Works Lafayette <br />CO <br />3,000 <br />Fasick Concrete Denver <br />CO <br />4,800 <br />Others (smaller volumes) Varies <br />CO <br />30,375 <br />Totals <br />a 0 b 46,875 c 0 <br />3. AMOUNT SENT OFFSITE (Be as specific as possible) <br />Note: If you have a product that comes in as one material and <br />is sent out <br />as another (e.g_, a computer monitor received as electronics <br />that is processed at your facility into glass and metal), please list <br />the incoming recyclable material under material collected and then <br />list the outgoing material under the new material category sent <br />offshe for <br />direct use as a product or for further processing. <br />Destination Name City/County <br />State <br />Amount Sent Amount Sent <br />as Product for Further Processing <br />Quality Contracting Denver <br />CO <br />2,500 <br />Naranjo Greeley <br />CO <br />1,500 <br />BTC Henderson <br />CO <br />500 <br />EZ Excavating Longmont <br />CO <br />500 <br />Totals <br />a 5,000 b 0 <br />4. COMMENTS OR CLARIFICATION <br />Material sent off site was crushed asphalt from the asphalt and asphalt fragments removed from loads received at the <br />facility. The material used by the facility was placed into the pit according to the DRMS mining permit for the Aggregate <br />Ind. site. <br />If you would like confirmation of receipt of your form, provide your email address: molenassoeiates@gmail.eom <br />Due May 1, 2012 <br />