2015-09-15_REPORT - M1981108

• Permit No: M1981108
• IBM Index Class Name: REPORT
• Doc Date: 9/15/2015
• Doc Name: Annual Fee, Report & Map
• From: Blue Mountain Stone
• To: DRMS
• Email Name: MAC
• Media Type: D
• Archive: No

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Division records indicate the following permittee contact information. If this information is not current, please type or
print current contact information:
Permittee Contact:
Abe Vasquez
Permittee Company:
Blue Mountain Stone
Address:
4168 Ute Hwy
Longmont, CO 80503
Phone Number:
[phone]
Fax Number:
[phone]
Email Address:
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.
orate Officer, Owner, or Documented Designee
M -AF -01
Date