2017-02-28_REPORT - M1993059

• Permit No: M1993059
• IBM Index Class Name: REPORT
• Doc Date: 2/28/2017
• Doc Name: Annual Fee/Report/Map
• From: Midwestern Farms
• To: DRMS
• Annual Report Year: 2017
• Email Name: AME
• 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: George Tempel
Permittee Company: Midwestern Farms
Address: P.O. Box 246
Wiley, CO 81092
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Permitting Contact: 4ee-E-Baxter
Company: Eastern Colorad Aggregates
Address: P.O. Box 580
Rye, CO 80169
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Inspection Contact: Joe-e.Baxter
Company: Eastern Colorado Aggregates �I
Address:
P. O. Box 580
Rye, CO 81069
Phone Number: [phone]
Fax Number: [phone]
Email Address:
I,the u dersigned, hereby state tljat the information provided in this report is true and accurate, and that site operations are
being c ducted in accordance with the Division a r ved mining and reclamation plans.
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Sig ture of Per ittee r orate Officer, ner,or Documented Designee Date
M-AF 01