2015-07-14_REPORT - M1980020

• Permit No: M1980020
• IBM Index Class Name: REPORT
• Doc Date: 7/14/2015
• From: ARS Sand & Gravel
• To: DRMS
• Annual Report Year: 2015
• Permit Index Doc Type: Annual Fee/Report
• Email Name: TOD
• Media Type: D
• Archive: No

Page 5 of 5
Division records indicate the following permittee contact information. If this information is not current, please type or
print current contact information:
Permittee Contact:
RoyMayfield
Permittee Company:
ARS Sand & Gravel Co LLC
Address:
8505 W. Mtn. View Ln.
Littleton, CO80125
Phone Number:
[phone]
Fax Number:
[phone]
Email Address:
[e-mail]
I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are
being conducted j*,accordance with the Division approved mining and reclamation plans.
Signature ofPefmittee, Corporate Officer, Owner, or Documented Designee
%I -AF -01
6/-1y/I
Date