2017-08-30_REPORT - M2005069

• Permit No: M2005069
• IBM Index Class Name: Report
• Doc Date: 8/30/2017
• Doc Name: Annual Fee Notice
• From: DRMS
• To: EnCana Oil & Gas ‎(USA)‎, Inc.
• Annual Report Year: 2017
• 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:

Regulatory Dept / Jason Eckman
Permittee Company:

EnCana Oil & Gas (USA), Inc.
Address:

143 Diamond Ave
Parachute, CO 81635

Phone Number:

[phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact:

Jim Stover
Company:

J.E. Stover & Associates
Address:

P.O. Box 60340
2352 North 7th Street
Grand Junction, CO 81506

Phone Number:

[phone]
Fax Number: [phone]
Email Address:
Inspection Contact:

Jason Eckman
Company:

EnCana Oil & Gas (USA), Inc.
Address:

143 Diamond Ave
Parachute, CO 81635

Phone Number:

[phone]
Fax Number: [phone]
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 Date
M-AF-01