_PERMIT FILE - M2013026

• Permit No: M2013026
• IBM Index Class Name: Permit File
• Doc Name: Other Applications
• Media Type: D
• Archive: No

Water Quality Control Division—Stormwater www.coloradowaterpermits.com
B. Permitted Project/Facility Information
Project/Facility Name
Street Address or cross streets
City, Zip Code County
Facility Latitude/Longitude—(approximate center of site to nearest 15 seconds using one of following formats
001A Latitude Longitude (e.g.,39.703°, 104.933°')
degrees(to 3 decimal places) degrees(to 3 decimal places)
or
001A Latitude ° Longitude ° "(e.g., 39°46'11"N, 104°53'11"W)
degrees minutes seconds degrees minutes seconds
C. STANDARD INDUSTRIAL CLASSIFICATION(SIC)CODE(S)FOR THIS FACILITY
(See Appendix A-include up to 4 in order of importance).
a. b. C. d.
D DESCRIBE THE INDUSTRIAL ACTIVITIES WHICH TAKE PLACE ON THIS SITE
Describe the primary industrial activities at this facility(e.g.,trucking firm with vehicle maintenance; computer equipment manufacturer;
automobile or scrap metal recycling; precious metal mining, milling, metal mining services; coal mine etc.). Indicate whether or not the
facility has a coal pile. If this application is for any of the following types of facilities, also provide the additional information indicated:
Airport:state the estimated volume of deicers used,and the volume of fuel sold, on an annual basis.
Wastewater treatment plant: include the design flow and pretreatment program status.
Steam electric power plant: indicate the primary and backup fuel sources.
Paving and roofing materials manufacturing: indicate whether or not the facility manufactures asphalt emulsion.
Asphalt or concrete batch plant: indicate whether or not the plant is portable.
Description:
E. RECEIVING WATERS
Identify the receiving water of the stormwater from the industrial facility. Receiving waters are any waters of the State of Colorado including
all water courses,even if they are usually dry. If stormwater from the facility enters a ditch or storm sewer system, identify that system and
indicate the ultimate receiving water for the ditch or storm sewer. Note:a stormwater discharge permit does not allow a discharge into a
ditch or storm sewer system without the approval of the owner/operator of that system.
Immediate Receiving Water(s):
Ultimate Receiving Water(s):
Page 3 of 8 Revised 3/2011