2015-10-27_REPORT - M1990093

• Permit No: M1990093
• IBM Index Class Name: REPORT
• Doc Date: 10/27/2015
• From: High Flume Gravel Pit, Inc.
• To: DRMS
• Annual Report Year: 2015
• Permit Index Doc Type: Annual Fee/Report
• 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:
Matt R. Carnahan
Permittee Company:
High Flume Gravel Pit, Inc.
Address:
C/o Four Corners Materials
P.O. Box 1969
Bayfield, CO 81122-1969
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 inccordance with the Division approved mining and reclamation plans.
Z ,
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Signature of Pei nittee, Corporate Officer, Owner, or Documented Designee
M -AF -01
1°/21/2 -vi
Date