2017-10-31_REPORT - M2004031

• Permit No: M2004031
• IBM Index Class Name: Report
• Doc Date: 10/31/2017
• Doc Name: Annual Fee/Report/Map
• From: Aggregate Industries - WCR, Inc.
• To: DRMS
• Annual Report Year: 2017
• Email Name: JLE
• 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: Connie Davis
Permittee Company: Aggregate Industries-WCR,
Inc.
Address: 1687 Cole Blvd., Ste. 300
Golden,CO 80401
Phone Number: [phone]
[phone]
Fax Number: [phone]
[phone]
Email Address: [e-mail]
Permitting Contact: Pam Hora
Tom Hesseman
Company: Tetra Tech RMC
Address: 1900 S. Sunset, Ste 1-F
Longmont,CO 80501
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Inspection Contact: Mike Refer Connie Davis
Company: Aggregate Industries-WCR,
Inc.
Address: 1687 Cole Blvd., Ste. 300
Golden,CO 80401
Phone Number: [phone] [phone]
Fax Number: [phone]
[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.
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Signature of Permittee, Corporate Officer,Owner,or Documented Designee Date
M-AF-01