2017-02-21_REPORT - M2005050

• Permit No: M2005050
• IBM Index Class Name: Report
• Doc Date: 2/21/2017
• Doc Name: Annual Fee Notice
• From: DRMS
• To: Rimrock Exploration & Development, Inc.
• Annual Report Year: 2017
• 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:

Alan Chiles
Permittee Company:

Rimrock Exploration &
Development, Inc.

Address:

P.O. Box 430
Nucla, CO 81424

Phone Number:

[phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact:

Alan Chiles
Company:

Rimrock Exploration and
Development Inc.

Address:

P.O. Box 430
Nucla, CO 81424

Phone Number:

[phone]
Fax Number:
Email Address:
Inspection Contact:

Alan Chiles
Company:

Rimrock Exploration and
Development Inc.

Address:

P.O. Box 430
Nucla, CO 81424

Phone Number:

[phone]
Fax Number:
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.

Signature of Permittee, Corporate Officer, Owner, or Documented Designee Date
M-AF-02