2016-03-14_REPORT - M2007010

• Permit No: M2007010
• IBM Index Class Name: Report
• Doc Date: 3/14/2016
• Doc Name: Annual Fee, Report and Map
• From: Weber Sand & Gravel, Inc.
• To: DRMS
• Annual Report Year: 2016
• 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:
Andy Weber
Permittee Company:
Weber Sand & Gravel, Inc.
Address:
2980 E. Hwy. 160
Pagosa Springs, CO 81147
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 in accordance with the Division approved mining and reclamation plans.
J.,042A)
Signat e of '7 rmittee, Corporate Officer, Owner, or Documented Designee Date
M -AF -01