2011-12-16_REVISION - M2006003

• Permit No: M2006003
• IBM Index Class Name: REVISION
• Doc Date: 12/16/2011
• Doc Name: Slurry Walls Liner Approval
• From: DNR Water Resources
• To: DRMS
• Email Name: ECS
• Media Type: D
• Archive: No

-3-
11. CoMresoondence BlfoMation:
APPLICANT/OPERATOR (name, address. and phone of name to be used on permit)
Contaet's Name: Je O Qr�
Company Name: It W i N r pa ra- l o iJ
Street/P.O. Box:
Title:. P4500 eves /,11Qr
P.O. Box:
City: A Ili kely
State: Mo racto Zip Code: S-05 Lf 3
Telephone Number. (_ i 2.0_ _ t - 5!R? AOO
Fax Number: A20 - 35,2- - 6,9 V
PERMITTING CONTACT (if different from applicant/operator above) y�/
Contacts Name: n n n ol_ Q r Tt z- Title: r jLi n /'1 ef-
Company Name: C p• fee 5000 -CeS
StreeW.O. Box: q,-,) DAL Sf S4 e- 20 P.O. B=: !Q $ 0
City: r;c -!c
State: 0,0 zip Cade: 9053 D
Telephone Number: 3D L33 -1 LI14
Fax Number; ( 303 >,- 833 - oL$ r0
INSPECTIONCONTACT
Contact's Name:
Company Name:
Streew.O. Box:
City:
State:
Telephone Number:
Fax Number:
0 zip Code: 8D5 �3
58 ? - IUDO
70 35a- G 1-8 y
Agency:
Street:
City:
State:
Telephone Number:
� : I .: W:11 ►1f ►L ' a
Agency:
Street:
City:
State:
Telephone Number. j 1-
Zip Code:
Zip Code: