2017-07-14_REPORT - M1977231

• Permit No: M1977231
• IBM Index Class Name: REPORT
• Doc Date: 7/14/2017
• Doc Name: Annual Fee/Report/Map
• From: First Bentonite Company CO
• To: DRMS
• Annual Report Year: 2016
• Email Name: TC1
• 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: Pamela Wedige
Permittee Company: First Bentonite Company
Colorado
Address: 215 Teller St.
Salida, CO 81201
Phone Number: [phone]
Fax Number:
Email Address:
Permitting Contact: Pamela Wedige
Company: First Bentonite Company
Colorado
Address: 215 Teller St.
Salida,CO 81201
Phone Number: [phone]
Fax Number:
Email Address:
Inspection Contact: Pamela Wedige
Company: First Bentonite Company
Colorado
Address: 215 Teller St.
Salida, CO 81201
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
being conducted in accordance with the Division approved mining and reclamation plans.
O
Signature of Permittee,Corpo Officer,Owner,or Documented Designee Date
M-AF-01