2016-12-21_REPORT - M1977094

• Permit No: M1977094
• IBM Index Class Name: REPORT
• Doc Date: 12/21/2016
• Doc Name: Annual Fee/Report/Map
• From: Morgan Sand & Gravel
• To: DRMS
• Annual Report Year: 2016
• Email Name: JLE
• 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: Greg Westhoff
Permittee Company: Morgan Sand& Gravel Inc
Address: 21215 Hwy No 52
P.O. Box 1443
Fort Morgan, CO 80701
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact: Greg Westhoff
Company: Morgan Sand&Gravel Inc
Address: 21215 Hwy No 52
P.O. Box 1443
Fort Morgan, CO 80701
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Inspection Contact: Greg Westhoff
Company: Morgan Sand&Gravel Inc
Address: 21215 Hwy No 52
P.O. Box 1443
Fort Morgan, CO 80701
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.
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Signature oaermittee Coro a Officer,Owner,or Documented Designee Date
M-AF-01