2017-06-05_REPORT - M2006017

• Permit No: M2006017
• IBM Index Class Name: REPORT
• Doc Date: 6/5/2017
• Doc Name: Annual Fee/Report/Map
• From: Premier Silica LLC
• To: DRMS
• Annual Report Year: 2017
• Email Name: TC1
• Media Type: D
• Archive: No

Page 5 of
Division records indicate the following permittee4andowner contact information(blank fields indicate that we do not have
information on record). If this information is blank orliot current,please type or print current contact information:
Permtttec Contact: Michael S. Miclette
Permittee'Company: Premier Silica LLC
Address: 5205 N.O'Connor Blvd., Suite 200
Irving,TX 75039
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
premiersilica.com
Permitting Contact: Michael S. Miclette
Company: Premier Silica LLC
Address: 5205 N.O'Connor Blvd., Suite 200
Irving,TX 75039
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
premiersilica.com
Inspection Contact: Michael S. Miclette
Company: Premier Silica LLC
Address: 5205 N.O'Connor Blvd., Suite 200
Irving,TX 75039
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
1,the undersigned, hereby state that the information provided in this report is true and accurate,and that site operations are
being conducted° accordance with the Division approved mining and reclamation plans.
Or
Signituii of Permittee Coro to Officer,Owner,or Documented Desienee Date
M-AF-OI