2017-07-17_REVISION - M1974070

• Permit No: M1974070
• IBM Index Class Name: Revision
• Doc Date: 7/17/2017
• Doc Name: Request For Surety Release
• From: Lafarge West, Inc.
• To: DRMS
• Type & Sequence: SL2
• Email Name: PSH
• Email Name: WHE
• Media Type: D
• Archive: No

In accordance with Rule 4.17.1(4), if requesting a full or partial acreage release the Operator or their
agent MUST sign that they have complied with the following statement: "All applicable portions of the
Reclamation Plan requirements have been satisfied in accordance with these Rules and all applicable
requirements under the Act."
Signature of Permittee,
or their authorized agent
7 1-r
Date
Important. In accordance with Rules 4.14 2(a) and 4.17.10)This release request must be submitted
to the Division via cern ted mail and se arate from any other correspondence to the Division.