2016-12-06_REPORT - M2011027

• Permit No: M2011027
• IBM Index Class Name: REPORT
• Doc Date: 12/6/2016
• Doc Name: Annual Fee/Report/Map
• From: Wamsley Pit
• To: DRMS
• Annual Report Year: 2016
• Email Name: PSH
• Media Type: D
• Archive: No

Page 5 of 5
Division records indicate the following permittee/landowner contact information(blank fields indicate that we do not have
information on record). If this information is blank or not current,please type or print current contact information:
Permittee Contact: Richard L.Wamsley
Permittee Company: Richard L Wamsley dba-RLW
Enterprises
Address: 3465 County Road 11
Walden, CO 80430
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Permitting Contact: Richard L.Wamsley
Company: Richard L Wamsley dba-RLW
Enterprises
Address: 3465 County Road 11
Walden, CO 80430
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Inspection Contact: Richard L.Wamsley
Company: Richard L Wamsley dba-RLW
Enterprises
Address: 3465 County Road 11
Walden, CO 80430
Phone Number: [phone]
Fax Number: [phone]
Email Address:
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.
fee
Signature of Permittee Corporate icer,Owner,or Documented Designee Date
M-AF-01