2017-06-19_REPORT - M1990057

• Permit No: M1990057
• IBM Index Class Name: REPORT
• Doc Date: 6/19/2017
• Doc Name: Annual Fee/Report/Map
• From: Union Milling Company, LLC
• To: DRMS
• Annual Report Year: 2017
• Email Name: DMC
• 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: Nick Michael
Permittee ompany: Union Milling Company,LLC
Address: P.O. Box 620490
Littleton,CO 80162-0490
Phone Number: [phone]
Fax Number:
Email Address: [e-mail]
Permitting Contact: Nick Michael
Company: Union Milling Company,LLC
Address: 6200 S. Vivian Street
Littleton, CO 80127
Phone Number: [phone]
Fax Number:
Email Address: SA v\r_ Any Ails, JZ
Inspection Contact: Nick Michael
Company: Union Milling Company,LLC -/
Address: 6200 S. Vivian Street
Littleton, CO 80127
Phone Number: [phone]
Fax Number:
Email Address: S Ac, ��✓x
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 Desianee Date
M-AF-02