2016-12-01_REPORT - M2006013

• Permit No: M2006013
• IBM Index Class Name: REPORT
• Doc Date: 12/1/2016
• Doc Name: Annual Fee/Report/Map
• From: Potts Pit #2
• To: DRMS
• Annual Report Year: 2016
• Email Name: MAC
• 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.
It'"I'II,.ANNUAL FEE SUBMI'I-I'ALS ARE NO f RECEIVED ON OR BEFORE YOUR ANNIVERSARY DATE,
THE I:NFORCEMENT PROCESS WILL AUTOMATICALLY BE [WrIATED. ENFORCE�1E T ACTIONS
MAY RESUL"I' IN CIVIL PENAL I'IES AND/OR RL•'VOC;ATION OF YOUR PERMIT.
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