2015-08-13_REPORT - M2007069

• Permit No: M2007069
• IBM Index Class Name: REPORT
• Doc Date: 8/13/2015
• Doc Name: Annual Fee, Report & Map
• From: Tony J. Beltramo & Sons
• To: DRMS
• 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:
1,
RobertBeltramo
Permittee Company:
Tony J. Beltramo and Sons, Inc.
Address:
1541 Stockyard Road
Pueblo, C081001
Phone Number:
[phone]
Fax Number:
�I q ,,r� � ����•7
Email Address:
•r,)F J3 5014yiNGe QLV
ET
7i0Ff ZA. . N9:7-
I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are
being conducted in accordance with the Division approved mining and reclamation plans.
Signature
M -AF -01
A
rate Officer, Owner, or Documented Designee
Date