2017-06-20_REPORT - M1982058

• Permit No: M1982058
• IBM Index Class Name: REPORT
• Doc Date: 6/20/2017
• Doc Name: Annual Fee/Report/Map
• From: Rocky West Mining Corp. c/o. Alvin Mosch
• To: DRMS
• Annual Report Year: 2017
• Email Name: MAC
• Media Type: D
• Archive: No

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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: Alvin Mosch ,AarD
Permittee Company: Rocky West Mining Corp. c/o V-
Alvin Mosch
Address: P.O.Box 1484
Idaho Springs, CO 80452
V
Phone Number: [phone]
U
Fax Number:
V
Email Address: [e-mail] V
Permitting Contact: David Mosch
Company: Rocky West Mining Corp.c/o
Alvin Mosch
Address: P.O. Box 1484
Idaho Springs,CO 80452 V
Phone Number: (393�6-7 — /�,5 ,
(, J 3gs -36
Fax Number:
it
Email Address: [e-mail] V
Inspection Contact: Alvin Mosch V
Company: Rocky West Mining Corp.c/o
Alvin Mosch
Address: P.O.Box 3244
Idaho Springs,CO 80452 V
Phone Number: [phone] ✓
Fax Number:
Email Address: ✓
I,the undersigned,hereby state that the information provided in this report is true and accurate, and that site operations are
bein conducted in accordance with the Division approved mining and reclamation plans.
ignature of Permittee,Corporate Officer,Owner,or Documented Designee Date
M-AF-02