2015-09-22_REPORT - M1987044

• Permit No: M1987044
• IBM Index Class Name: REPORT
• Doc Date: 9/22/2015
• Doc Name: Annual Fee, Report, & Map
• From: Elam Construction, Inc. dba Sandco, Inc.
• To: DRMS
• Email Name: LJW
• 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:
Mr. Russ Larson
Permittee Company:
Elam Construction, Inc., dba
Sandco Inc.
Address:
556 Struthers Ave.
Grand Junction, CO 81501
Phone Number:
0110 2-4?- S3 -f 0
Fax Number:
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 accordynce with the Division _Tproved mining and reclamation pians.
Signature of
M -ARM
or Dmmentg7d De nee Date