General Order Application: Stationary and Portable Rock Crushers DEPARTM ENT O F

ECOLOGY State of Washington

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. .

I ✓ I Read the Stationary and Portable Rock Crusher General Order. You can find it online at https ://ecology. wa. gov /Regulations-Permits/Permits-certifications/ Air-Quality-permits/ Air-qua! ity-general-orders, or call the appropriate regional office (see below) for a copy. -,., 0 __..

l ✓ I Fill out the application completely, sign it and date it. ~~ \0 ~ ~ ;:_ 0 c:.> ' ' ...., l ✓ I Enclose a check to the Department of Ecology for the application fee. r:>,.., J,

State Environmental Policy Act (SEPA) Compliance ~ g 7:> D$500 application fee if SEPA review is complete - Include a copy of the final S~ che£ list and

SEPA determination (e.g. DNS, MONS, EIS) with your application. ·.:~ ~

I✓ 1$785 application fee if SEPA review is required - If SEPA review has not been conducted, please fill out a SEPA checklist and submit it with your application. You can find a SEPA checklist online at https :// ecology. wa. gov /Regulations-Perm its/SEP A/Environmental-review/SEPrl\,-guidance.

~ CJ Department of Ecology - ct> (1) "O D ~~!l _t~e _c~-~~ l~t~- ~~P! i~~ti~-~ -~~c~~g~ - ~o: ::a Cashiering Unit 3 ~ )> : For Fiscal Office Use Only: i m , 001-NSR-216-0299-000404 ' P.O. Box 47611 ~ §' ffi () I

I Ill (I) -Olympia, WA 98504-7611 Ch:::, --·-·-·-·- ·- · - ·- ·-·-·-·- · - •-·- •-• - •- •-· - •-· - ·-·I m -::T - 00 s· o ~

Check the box for the location of your proposal or if operating as a portable sourcegJ~ ne:fflocarf1n you will operate your rock crusher. For assistance, call the appropriate office listed beloa :~ CJ

::i: (C 0 ~

Chelan, Douglas, Kittitas, Klickitat, or Okanogan County co CRO Ecology Central Regional Office (509) 575-2490 Adams, Asotin, Columbia, Ferry, Franklin, Garfield, Grant, Lincoln, Pend Oreille,

Stevens, Walla Walla, or Whitman County ERO Ecology Eastern Regional Office (509) 329-3400

San Juan County NWRO Ecology Northwest Regional Office ( 425) 649-7000 For actions taken at Kraft and Sulfite Paper Mills and Aluminum Smelters only IND Ecology Industrial Section (360) 407-6900 For actions taken on the US Department of Energy Hanford Reservation only NWP Ecology Nuclear Waste Program (509) 372-7950

ECY 070-237 (Rev12/2018) Page 1 of 4

IL COMPANY INFORMATION

l. Company Name: Versatile Industries Inc. 2. Company Mailing Address (street, city, state, zip):

P.O. Box 275, lone, Wa. 99139 3. Company Contact Person, Title:

Kory Hedrick 4. Company Phone Number:

509-442-2444 5. Company Fax Number:

509-442-4442 6. Contact Person Phone Number:

509-671-7702 7. E-Mail Address:

viiexcavation@live.com

III. PLANT INFORMATION 1. Plant Name (A separate application must be filled out for each plant):

Crusher 1

2. Plant Operator:

Steve Hedrick

3. Plant Operator's Cell Phone Number:

509-936-0168 4. Plant Capacity (Tons per hour):

2000 5. Maximum Plant Hourly Capacity (Tons per hour):

Same 6. Are water spray bars or equivalent installed at all crusher discharge points and before all fines drop points?

[Z]Yes No 7. Will the plant be located a minimum of 150 feet from the property line?

[Z]Yes No A STATIONARY PLANTS

Ocheck 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?

Oves No 4. Will line power be used? OYes No (If line power is not used, a separate Notice of Construction air quality permit is required for power generators.)

ECY 070-237 (Rev12/2018) Page 2 of4

B. PORTABLE PLANTS I ✓ !Check this box and fill out this section if you 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: 15000 tons

Intended Dates of Operation: From: August To: Thru Sept

Site Name: USFS Tacoma Creek Pit County: Pend Oreille

Legal Description: Quarter _X __ ; Section _8 _ _ ; Township 34N ; Range 43E

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

2a. 1falll /10~ -S-~ Cf"'-5~ 2b. TT&ld- r'14'Mtt+- eo ne Engine manufacturer: Cr£1 Engine manufacturer: ulAN4,.,,»s Model: c1 Model: £"5Y-._ Year of manufacture: 200, Year of manufacture: Wlc Serial number: U2 'i 01:z_(o /)L#B. Serial number: Engine size: L-l~O hp Engine size: ~ 15""0 hp Max electrical output kWe Max electrical output kWe

Height of exhaust stack: n .. f-r feet Height of exhaust stack: 17- feet Fuel: 11 ,QS0-i Fuel: V,'~sel Maximum hourly fuel: (Q gal/hr Maximum hourly fuel: ~ gal/hr 2c. 11'~ ~o~+ Sl,(,utfl r1o-Vrt .... 2d. Engine manufacturer: CC( C"'--1 Engine manufacturer:

Model: c,q Model: Year of manufacture: 1-0 l\ Year of manufacture: Serial number: 9 -"Pool2~ L°'1BHwl1 Serial number: Engine size: !JOO hp Engine size: hp

Max electrical output kWe Max electrical output kWe

Height of exhaust stack: n .. .f+ feet Height of exhaust stack: feet Fuel: S),~5-e-\ Fuel : Maximum hourly fuel: Ct, gal/hr Maximum hourly fuel: gal/hr

3. Do you have a stationary water storage tank, separate from your primary water truck? OYes [2;jNo

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 (Rev12/2018) Page 3 of4

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

2. Scalping screen

3. Secondary crusher

4. Sizing screen

5. Tertiary crusher

6. Fines screen

7. Aggregate storage bins (If applicable)

8. Portable water storage (Water truck)

Gh~"j \l,J,}()Jl I~ D L-1 t+ ll,w G5t5(o(u8

(gallons)

i.,;oo 9. Conveyors

(Use separate sheet to list all)

10. Other equipment

(Add additional sheets as necessary)

11 . Other equipment

12. Other equipment

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

Printed Name I ~fj !J.e~'C\L Date

commodation, call Ecology at (360) 407-6800, 711 (relay service), or (877) 833-6341 (TTY).

ECY 070-237 (Rev1 2/20 18) Page 4 of4

)

NOTE:

COLUMBIA

OREGON

STATE MAP NOTTO SCALE

DRAWING SCALE IS ONLY ACCURATE WHEN PLANS ARE PLOTTED 11" X ff' (TABLOID) SIZED PAPER WITHOUT SCALING

0 l:

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To: Highway 20/Colville WA

TACOMA CREEK PIT CRUSHING SITE PLAN

SECTION 8 T34N R43E

ESTIMATE OF QUANTITIES TACOMA CREEK PIT-CRUSHING

Item Number

Description Unit Tacoma

Creek Pit

Project Total

15101 Mobilization Is I 1

31402 Stockpile aggregate, Section 703.05. grading C. (Base)

ton 10000 10000 Coowrsion factor of 1.S too /CY

Option Items

•31402A Stockpile aggregate. Section 703.05, grading C. (Base)

ton 5000 5000 Conversion factor of 1.5 too /CY

* Option items may be exercised upon award of contract. The G0\1.!rnment may award total or p:,rtion of optio~ based on mBilable fu:nds.

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II!!,

."' lil/J

) () lhcnluc In lhc parcutbc:11:s ii; the 11llo1vablc de\·intlon (±) from the tllJECl values.

GRADATION TABLE: STANDARD SPECIRCAfiONS FOR CONSTRUcnoN OF ROADS AND BRIDGES ON FEDERAL HIGHWAY PROJECTS (FP-1'), SECTION. 703, PAGE 656 '

N

To: Highway 20/ Cusick WA ® 0 2000' '4000'

k- I I DESIGNED

COLVILLE NATIONAL FOREST BY: j,,J_K SITE MAP AND ESTIMATE OF QUANTITIES : 20~) ~ NEWPORT RANGER DISTRICT _/'\; I I ;l'\PHECKEDBY: GAJ ;,# TACOMA CREEK PIT CRUSHING

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