2016-06-14_REPORT - M1995005

• Permit No: M1995005
• IBM Index Class Name: REPORT
• Doc Date: 6/14/2016
• Doc Name: Annual Fee/Report/Map
• From: Orchard Mesa Aggregates
• To: DRMS
• Annual Report Year: 2016
• Email Name: SJM
• Media Type: D
• Archive: No

If you have additional comments and/or information that should be provided to the Division,please provide it below
or attach it to this form along with your written report and map. Annual Report instructions are enclosed. If you have
any questions,please feel free to contact Scottie Tate([phone] ext 8166)or Michelle Ramirez([phone]
ext 8114). Thank you for your cooperation in this matter.
IF 1 I-lf \I_ FEE SFIrd EI 111 S A.kE NOT RECEIVED;UN OR BEI'OR1 1( )I' ANNJVFRSARY DA 1l=.
�;1L, i i'dl t�:;('l\ti r•l l'RO(Ii-'SS \Vll_I .\Lift_)i%;ATIC A11.1 BE IIS 11 '\l1.Ir. F 1 MEN I At +ION
)•11.01- lliti (WIT LT It .-'..ND.'OR i:EV+O(ATFi)N O 1C)tJI; i'l 'r'.irlli.