2015-09-08_REPORT - P2011028

• Permit No: P2011028
• IBM Index Class Name: Report
• Doc Date: 9/8/2015
• Doc Name: Annual Fee, Report & Map
• From: Terry Winters
• To: DRMS
• Email Name: MAC
• Media Type: D
• Archive: No

Page 6 of 6
Division records indicate the following permittee/landowner contact information. If this information is not current, please
type or print current contact information: Rule 5.6.1(a, b).
Permittee Contact: Terry Winters
Permittee Company: Terry Winters
Address: 1558 Spring Gulch Rd.
Box 178
Idaho Springs, CO 80452
Phone Number: 303) 567-4711
Fax Number:
Email Address:
Landowner Contact:
Landowner Address:
Landowner Phone
Number:
Landowner Email
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 NOI and reclamation plans. Rule 5.6.1(h).
of Peylnittee, Corporate Officer, Owner, or Documented Designee
P -AF -01
05,1(5111(315
Date