Mining Operations Apen - Form Apcd-222
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9Mining Operations APEN – Form APCD-222
Air Pollutant Emission Notice (APEN) and
Application for Construction Permit
All sections of this APEN and application must be completed for both new and existing facilities, including APEN
updates. An application with missing information may be determined incomplete and may be returned or result in
longer application processing times. You may be charged an additional APEN fee if the APEN is filled out
incorrectly or is missing information and requires re-submittal.
This APEN is to be used for mining operations (i.e. quarries, pits, or mines). This APEN may also be used to report
Haul Road activities at non-mining facilities. Additional APENs may be required for process equipment located in
the mine. A specialty APEN may be available for the process equipment (e.g. HMA plants, crushers/screens,
concrete batch plants, engines, etc.) If a specialty APEN is not available or does not satisfy your reporting needs,
the General APEN (Form APCD-200) is available. A list of all available APEN forms can be found on the Air Pollution
Control Division (APCD) website at:
This emission notice is valid for five (5) years. Submission of a revised APEN is required 30 days prior to expiration
of the five-year term, or when a reportable change is made (significant emissions increase, increase production,
new equipment, change in fuel type, etc). See Regulation No. 3, Part A, II.C. for revised APEN requirements.
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Permit Number:
AIRS ID Number:
[Leave blank unless APCD has already assigned a permit # and AIRS ID]
Section 1 – Administrative Information
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Company Name
:
Mine/Pit Name:
Mine/Pit Location
Mine/Pit Location:
County:
NAICS or SIC Code:
Mailing Address:
(Include Zip Code)
Permit Contact:
Phone Number:
2
E-Mail Address
:
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Please use the full, legal company name registered with the Colorado Secretary of State. This is the company name that will
appear on all documents issued by the APCD. Any changes will require additional paperwork.
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Permits, exemption letters, and any processing invoices will be issued by APCD via e-mail to the address provided.
Form APCD-222 – Mining Operations APEN - Revision 4/2016
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