2017-04-18_REPORT - M2001046

• Permit No: M2001046
• IBM Index Class Name: REPORT
• Doc Date: 4/18/2017
• Doc Name: Annual Fee/Report/Map
• From: Ready Mixed Concrete
• To: DRMS
• Annual Report Year: 2017
• Email Name: ECS
• 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: Joe Lamanna
Permittee Company: Ready Mixed Concrete
Company
Address: 11778 Highway 52
Fort Lupton,CO 80621
Phone Number: [phone]
Fax Number: None
Email Address: "-_ a— " ` `_
_ [e-mail]
Permitting Contact: Alan 1 l'>vrard Mike Hart
Company: Brierley Asseeietes Hart Environmental
Address: 2329 W Main St Ste 201 P.O.Box 1303
Boulder,CO 80306
Phone Number: [phone]
Fax Number: [phone] None
Email Address: [e-mail]
Inspection Contact: BiH Tit»met Joe Lamanna
Company: Ready Mixed Concrete
Company
Address: 4395 WashingteR St 11778 Highway 52
Fort Lupton,CO 80621
Phone Number: [phone] [phone]
Fax Number: None
Email Address: [e-mail]
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.
S' nat le of P it Cor or t7bfftmr,Owner,or Documented Designee Date I