2017-01-17_REPORT - M1977424

• Permit No: M1977424
• IBM Index Class Name: Report
• Doc Date: 1/17/2017
• Doc Name: Annual Fee/Report Notice
• From: DRMS
• To: Occidental Oil Shale
• Annual Report Year: 2017
• Permit Index Doc Type: Annual Fee/Report
• 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:

Mike Anderson
Permittee Company:

Occidental Oil Shale, Inc.
Address:

C/o Glenn Springs Holdings,
Inc.
5005 Lyndon B Johnson FWY
Ste 1350
Dallas, TX 75244-6150

Phone Number:

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

Franklin Miller
Company:

Occidental Oil Shale, Inc.
Address:

2480 Fortune Drive, Ste. 300
Lexington, KY 40509

Phone Number:

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

Bruce D. Smith
Company:

Western Water & Land, Inc.
Address:

743 Horizon Ct., Ste. 330
Grand Junction, CO 81506

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.

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