2017-08-20_REPORT - M2001068

• Permit No: M2001068
• IBM Index Class Name: REPORT
• Doc Date: 8/20/2017
• Doc Name: Annual Fee/Report/Map
• From: Tamrock Gravel LLC
• To: DRMS
• Annual Report Year: 2017
• Email Name: MAC
• Media Type: D
• Archive: No

Page 5 of 5
Division records indicate the following permittee/landownercontact
information( lank fields indicate that type or point current contact info`rmationot have
not current,
information on record). If this information is blank orPlease
Permittee Contact: Brent Tamburelli
Permittee Company: Tamrock Gravel LLC
Address: 137 East Plum St.
Trinidad,CO 81082
Phone Number: [phone]
Fax Number: [phone]
Email Address: CLAte4 �j L ;u,�. m
Permitting Contact: Joe Gagliano tJ
Company: Barnhart Agency, Inc.
Address: 212 W. 13th Street
Pueblo,CO 81003
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Inspection Contact: Brent Tamburelli
Company: Tamrock Gravel Company
Address: 137 Plum Street
Trinidad,CO 81082
Phone Number: [phone]
Fax Number: [phone]
Email Address:
41^-r0 i Jr'tt-4fre-[ i rh.t,.c 1 .6& -'-i
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 Date
M-AF-01