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• iiiiiiuiii <br /> FOR AGENCY USE <br /> :PPLICATION NUMBER <br /> NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM DATE RECEIVED <br /> APPLICATION FOR PERMIT TO DISCHARGE - SHORT FORM <br /> MUNICIPAL, INDUSTRIAL <br /> YEAR M0. DAY <br /> Do not attempt to complete this form before reading the accompanying instructions <br /> Please print or type <br /> 1. Name, address, and telephone number of the owner of the facility producing <br /> discharge. <br /> A. Owner Bestway Paving Company <br /> B. Facility name Pit No. 1 1 <br /> C. Mailing address P.O. Box 820 <br /> D. City Greeley D. State Colorado <br /> E. County Weld F. Zip Code 80631 <br /> G. Telephone Number ( 303 ) 353-1654 <br /> Area Code <br /> 2. Location of facility <br /> A. Legal brief description NEB, Sec. 2, TSN, R66W, 6th P.M. <br /> R. Street North 35th Avenue <br /> Greeley y Weld <br /> C. City D. Count <br /> E. State Colorado <br /> F. Telephone Number ( 303 ) 353-1654 <br /> Area Code <br /> G. Local contact Carl V. Hill , President <br /> 3. Sanitary discharges (only for sewage treatment facilities) . <br /> A. Unit treatment processes utilized N/A <br /> B. Design flow (average daily) of facility N/A MGD . <br /> C. Percent 600 removal (actual-previous year) N/A $ <br /> D. Population served N/A <br /> E. Number of discharge points N/A <br /> F. Description of discharge location(s) : N/A <br /> G. Name of receiving water(s): N/A <br /> H. Is land application used or planned? N/A <br /> I. Method of sludge disposal N/A <br /> J. (1) Do you receive industrial waste? N/A <br /> (2) If yes, describe the sources N/A <br /> K. Attach any laboratory analyses of your effluent quality <br />