2017-08-01_REPORT - M1976038

• Permit No: M1976038
• IBM Index Class Name: REPORT
• Doc Date: 8/1/2017
• Doc Name: Annual Fee/Report/Map
• From: Meeker Sand & Gravel, Inc
• To: DRMS
• Annual Report Year: 2016
• Email Name: THM
• 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: Dan P.Conrado
Permittee Company: Meeker Sand&Gravel, Inc.
Address: 3251 RBC#4
P.O. Box 1550
Meeker, CO 81641
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact: 3eQ cAlwade--
Dan P. Conr'Qdv
Company: Meeker Sand&Gravel, Inc.
Address: 3251 RBC 44
P.O. Box 1550
Meeker,CO 81641
Phone Number: [phone]
Fax Number:
Email Address:
Inspection Contact: Jecemri-M&
Tan P, Conrada
Company: Meeker Sand&Gravel, Inc.
Address: 3251 RBC#4
P.O. Box 1550
Meeker, CO 81641
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.
Signature of Permittee,Corporate Officer,Owner,or Documented Designee ate
M-AF-01