2017-11-07_REPORT - M2009074

• Permit No: M2009074
• IBM Index Class Name: Report
• Doc Date: 11/7/2017
• Doc Name: Annual Fee/Report/Map
• From: Colorado Backhoe Service
• To: DrMS
• Annual Report Year: 2017
• Email Name: ERR
• Media Type: D
• Archive: No

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'Permittee-r-ompany:
ColoradoBa&hoe Service
Address:
25193 South Road
Pueblo, CO 81006
Phone Number:
[phone]
Fax Number:
Email Address:
[e-mail]
Permitting Contact:
Stevan L. O'Brian (Steve)
Company:
Environment, Inc.
Address:
7985 Vance Dr Ste 205A
Arvada, CO 80003
Phone Number:
[phone]
Fax Number:
[phone]
Email Address:
Inspection Contact:
Thomas Joseph
Company:
Colorado Backhoe Service
Address:
25193 South Road
Pueblo, CO 81006
Phone Number:
[phone]
Fax Number:
-21 r �y
Email Address:
[e-mail]
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
M- AF -01
&a
Date