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General Order Application: Stationary and Portable Rock Crushwll P7 :s9DEPARTM EN T OF

ECOLOGY State of Washingto n DEPT . 0; t C O nG'f

' ~ . ,: i' • •·I. INSTRUCTIONS

This application applies statewide for facilities under the Department of Ecology's jurisdiction. Fill out the form completely in order to obtain coverage.

!){ Read the Stationary and Portable Rock Crusher General Order. You can find it online at www.ecy.wa.gov/programs/air/AOP Permits/Boiler/Genera!Orders.htm, or call the appropriate regional office (see below) for a copy.

~ Fill out the application completely, sign it and date it.

pi{ Enclose a check to the Department of Ecology for the application fee. L ..

State Environmental Policy Act (SEPA) Compliance ,) [-..,,r ~ $500 application fee if SEPA review is complete - Include a copy of the fi - SEP A thed<list ,and

SEPA determination ( e.g. DNS, MDNS, EIS) with your application. .:;{e, ·' • • '"'"· ,., .·\:,y -". -· • ._,·;,J"'� $785 application fee if SEPA review is required - If SEPA review has not been conducted, please fu

out a SEPA checklist and submit it with your application. You can find a SEPA checklist online at www.ecy.wa.gov/programs/sea/sepa/docs/echecklist.doc .

.,t' Mail the complete application package to : Department of Ecology :· -. -. -. -. F;;-i"is·;;iojjz~; 'us""e· o~i;.-·-.-.-.-. ; Cashiering Unit , 001-NSR-216-0299-000404 ' P.O. Box 47611 I I Olympia, WA 98504-7611 ~-- ·-•-·- ·- ·- ·-·- ·- ·-·-·-·-·-·- ·-·- ·-·-·- ·- ·-•l

Check the box for the location of your proposal or if operating as a portable source, the next location you will operate your rock crusher. For assistance, call the appropriate office listed below:

�

� �

�

Chelan, Douglas, Kittitas, Klickitat, or Okanogan County Ecology Central Regional Office (509) 575-2490

Adams, Asotin, Columbia, Ferry, Franklin, Garfield, Grant, Lincoln, Pend Oreille, Stevens, Walla Walla, or Whitman County Ecology Eastern Regional Office (509) 329-3400

San Juan County Ecology Northwest Regional Office (425) 649-7000

For actions taken at Kraft and Sulfite Paper Mills and Aluminum Smelters only Ecology Industrial Section (360) 407-6900

For actions taken on the US Department of Energy Hanford Reservation only Ecology Nuclear Waste Program (509) 372-7950

CRO

ERO

NWRO

IND

NWP

ECY 070-237 (Rev. 2/2012) Page 1 of 4

II. COMPANY INFORMATION 1. CompanyName:

2. Company Mailing Address

5V . 3. Company Contact Person, Title:

6. Contact Person Phone Number:

-::fo --~ - qoBo

III. PLANT INFORMATION

(_,,.

Ol 4. Company Phone Number:

· :i--oi -- -::t-,1 Li -- 85 l -\

7. E-Mail Address :

t)rQJA~ n \ .g

5. Company Fax Number:

1. Plant Name (A separate application 2. Plant Operator: 3. Plant Operator's Cell must be filled out for each plant): Phone Number:

·--r;.,n ~tLW P\a.-A ·.\- BrCW) J.on u.rbcvkkw 1o i -S-:f-o·-4060 4. Plant Capacity (Tons per hour) : 5. Maximum Plant Hourly Capacity (Tons per hour):

1'251} -1-50 6. Are water spray bars or equivalent installed at all 7. Will the plant be located a minimum of 150 feet crusher discharge points and before all fines drop from the property line? points?

� Yes EINo ~Yes � No

A. STATIONARY PLANTS

D Check this box and fill out this section if you are initially locating your rock crusher as a stationary source.

1. Facility Location (If different from company mailing address): 2. County:

3. Do you have pressurized line water supply?

� Yes � No

4. Will line power be used? � Yes � No

(If line power is not used, a separate Notice ofConstmction air quality permit is required for power generators.)

ECY 070-237 (Rev. 2/2012) Page 2 of 4

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B. PORTABLE PLANTS ~ Check this box and fill out this section ifyou are initially locating your rock crusher as a portable source

1. Temporary Location Information (Please include information for your next anticipated operating location):

Quantity of Material to be Produced: g)) GQQ tons

Intended Dates of Operation: From: L--J 1/ I ) W l2> To: 1li / I / .ZO)8 I /1 i

Site Name: tpbN1..Jo..., -~a..,7t: P;~ County: U reun }-Legal Description: Quarter\J ~ ; Section i ~ ; Township lJ.ll_; Range U C.

2. Provide manufacturer's specification infonnation on any power generators listed below. Attach additional sheets if there are more than 4 units.

2a. 2b. Engine manufacturer: Engine manufacturer:

Model:

CJ1U/ Dvtno>l­Model:Sco /i tJ

Year of manufacture: Year of manufacture:Zo ll Serial number: ~ 2...ll-DA- - 1-1---oz t 1 Serial number:

Engine size: _ =_ _ 4__·-----'"f'-----'.._~.._____hp Engine size: ________hp

Max electrical output 560 kWe . Max electrical output ________kWe I --rof, o~v~Height of exhaust stack: 3 JOX'1 feet I i Height of exhaust stack: _________feet

Fuel: f){ 0s-u\ Fuel:

Maximum hourly fuel : ~\0~ 5~•~i-:\~ __gal/hr Maximum hourly fuel: --------gal/hr

2c.

Engine manufacturer:

Model:

Year of manufacture:

Serial number:

Engine size:

Max electrical output

Height of exhaust stack:

Fuel:

Maximum hourly fuel:

_________hp

kWe

feet

________gal/hr

2d. Engine manufacturer:

Model:

Year of manufacture:

Serial number:

Engine size:

Max electrical output

Height of exhaust stack:

Fuel:

Maximum hourly fuel:

_________hp

kWe

feet

gal/hr

3. Do you have a stationary water storage tank, separate from your primary water truck? D Yes D No

If yes, what is the storage capacity of your water storage tank? _____ gallons

Note: If you do not have a stationary water storage tank separate from your primary water truck, you will need to have a pressurized line water supply available at every location you operate.

ECY 070-237 (Rev. 2/2012) Page 3 of 4

IV. EQUIPMENT INFORMATION (Use a separate sheet if additional equipment not listed below is used at this rock crushing plant.)

Process -

Equipment Description (Manufacturer, model, size)

Identification (Equipment ID

or serial number)

Date Purchased

Capacity (Tons per hour or as

noted) 1. Primary jaw

crusher

, /\'Tr~G> \--Z..~ 5 2. Sa.-w MG03 V;\o ?-50

2. Scalping screen 1rio :SCU-J (-)re,. :..-.Svr6Vli (Y)~o'b l.0\0 '2... 50 3. Secondary crusher

4. Sizing screen

5. Tertiary crusher

6. Fines screen

7. Aggregate storage bins (If applicable)

8. Portable water storage (Water truck)

1;r-i t=& 5""9 t.Jf"O L{ W\O (gallons)

1-,(JOD

9. Conveyors (Use separate sheet to list all)

\I \

30.i< \5olL.P \ /-s 0 I .~t.7 ,. 1l..,.. r

(VYT08 1,o 1; 1-59

10. Other equipment

(Add additional sheets as necessary)

\\ \

4 2, X l&; 1=="°~-G,,1-a-b ·h:.,e, Mv:o-z_ 'lot t rz-50 11. Other equipment

12. Other equipment

V. SIGNATURE BLOCK

Signature

1 certify, based on information and beliefformed after reasonable inquiry, the statements and information in this application are true, accurate, and complete.

If you need this document in a format for the visually impaired, call the Air Quality Program at 360-407-6800. Persons with hearing loss can call 711 for Washington Relay Service. Persons with a speech disability can call 877-833-6341.

ECY 070-237 (Rev. 2/2012) Page 4 of 4

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IV. EQUIPMENT INFORMATION (Use a separate sheet if additional equipment not listed below is used at this rock crushing plant.)

Identification Capacity

Process Equipment Description (Equipment ID Date (Tons per

(Manufacturer, model, size) or serial Purchased hour or as number) noted)

1. Primary jaw crusher

2. Scalping screen

3. Secondary crusher

4. Sizing screen

5. Tertiary crusher

6. Fines screen

7. Aggregate storage bins (If applicable)

8. Portable water (gallons) storage (Water truck)

9. Conveyors Sup~ '. or Si ~~-S+a...c(Use separate {'1)-B 18 P-- WI~ 1--50 sheet to list all) 3 ✓ p:uk. 0>nveL(GJ 3t/ '(<no

10. Other equipment

(Add additional sheets as necessary) 11. Other equipment

12. Other equipment

V . SIGNATURE BLOCK 1 certify, based on information and belief formed after reasonable inquiry, the statements and information in this application are true, accurate, and complete.

Printed Name Title ______________

Signature Date 1rl l4 {VJ\ ~ If you need this docu ment in a format for the visually impaired, call the Air Quality Program at 360-407-6800. Persons with hearing loss can call 711 for Washington Relay Service. Persons with a speech disability can call 877-833-6341 .

ECY 070-237 (Rev. 2/2012) Page 4 of 4