2015-10-30_REPORT - M1977193

• Permit No: M1977193
• IBM Index Class Name: REPORT
• Doc Date: 10/30/2015
• From: Tezak Heavy Equipment Co. Inc.
• To: DRMS
• Annual Report Year: 2015
• Email Name: TC1
• 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:
Randy DiLuzio
Permittee Company:
Tezak Heavy Equipment Co. Inc.
Address:
205 Tunnel Dr.
Canon City, CO 81212
Phone Number:
[phone]
Fax Number:
[phone]
Email Address:
[e-mail]
1, the unders4 ned, hereby state that the information provided in this report is true and accurate, and that site operations are
being coqKctd in accgrdanceMith th¢ Division approved mining and reclamation plans.
Signature of
M -M-41
Owner, or Documented Designee
Date