1 SAN DIEGO AIR POLLUTION CONTROL DISTRICT 2 SUPPLEMENTAL APPLICATION San Diego APCD Use Only INFORMATION FEE SCHEDULES Appl. No.: 07A, B ID No.:

SAND, ROCK, AND AGGREGATE PLANTS

1Company Name:

2Equipment Address:

31. PLANT DESCRIPTION

4Location:

5Portable: Yes No Fixed: Yes No

6Proposed Date of Installation: Material Processed:

7Source/Location of Material:

8Operating Schedule: hrs/day days/week weeks/year Attach plan drawing showing entire plant configuration

92. CRUSHER SYSTEMS (07A)

10Primary Crusher: Manufacturer:

11 Size: Serial #: Throughput: tons/hr

12 Product: Inches Type of Dust Control:

14Secondary Crusher: Manufacturer:

15 Size: Serial #: Throughput: tons/hr

16 Product: Inches Type of Dust Control:

18Secondary Crusher: Manufacturer:

19 Size: Serial #: Throughput: tons/hr

20 Product: Inches Type of Dust Control:

22Tertiary Crusher: Manufacturer:

23 Size: Serial #: Throughput: tons/hr

24 Product: Inches Type of Dust Control:

263. MATERIAL SCREENING SYSTEM (07B)

27Primary Screen: Manufacturer:

28 Size: Serial #: Static or Vibrating:

3Rev. 3/03 1 of 2 (07A,B) OVER 30 # of Decks: Throughput: Product: inches

31 Serving Crusher #: Type of Dust Control:

4 2 of 2 (07A,B) 33Secondary Screen: Manufacturer:

34 Size: Serial #: Static or Vibrating:

36 # of Decks: Throughput: Product: inches

37 Serving Crusher #: Type of Dust Control:

39Tertiary Screen: Manufacturer:

40 Size: Serial #: Static or Vibrating:

42 # of Decks: Throughput: Product: inches

43 Serving Crusher #: Type of Dust Control:

454. MATERIAL CONVEYORS

46List all belt, screw, or bucket conveyors used to transfer material between equipment listed in Sections 2 and 3. 47Include belt widths, capacities, and lengths:

48

49

505. STATIONARY INTERNAL COMBUSTION ENGINE DESCRIPTION (If applicable)

51Manufacturer:

52Model: Serial #: Consumption: gal/hr

53Grade of Fuel: BHP Rating: Maximum Load: KW

546. HAUL ROAD DESCRIPTION (Attach Sketch)

55Surface: # of Lanes: Length: miles

56Road Dust Control: Frequency: Method:

57Speed Limit: mph Types of Vehicles:

58# of Wheels: Weight Empty: Weight Loaded:

597. MATERIAL STORAGE

60Method of Storage: Piles Yes No Enclosed Bins Yes No

61Volume of Material Storage:

62Type of Dust Control:

63Method of Loadout:

64Name of Preparer: Title :

65Phone No.: ( ) Date :

NOTE TO APPLICANT: Before acting on an application for Authority to Construct or Permit to Operate, the District may require further

5 2 of 2 (07A,B) information, plans, or specifications. Forms with insufficient information may be returned to the applicant for completion, which will cause a delay in application processing and may increase processing fees. The applicant should correspond with equipment and material manufacturers to obtain the information requested on this supplemental form.

6 2 of 2 (07A,B)