2017-11-08_REPORT - M1980131

• Permit No: M1980131
• IBM Index Class Name: REPORT
• Doc Date: 11/8/2017
• Doc Name: Annual Fee/Report/Map
• From: Elam Construction, Inc.
• To: DRMS
• Annual Report Year: 2017
• Email Name: GRM
• Media Type: D
• Archive: No

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Division records indicate the following perniitteellandowner contact information(blankTieldsindicate that we do nothave
information on record). If this information is blank or not current,please type or print current contact information
]permittee Camimet i Russel A_lam
Permittee Company I Elam Construction,I
Address: 556 Struthers Ave
Grand Junction, CO 81501-
3826
Phone Number: [phone]
Fax Number:
Email Address:
Permitting Contact: Stephen Kaspar
Company: Elam Construction, Inc.
Address: 556 Struthers Ave.
Grand Junction, CO 81501
Phone Number: [phone]
Fax Number:
Email Address:
Inspection Contact: Jon Mueller
Company: Elam Construction, Inc.
Address: 556 Struthers Ave.
Grand Junction, CO 81501-
3826
Phone Number: [phone]
Fax Number:
Email Address:
I,the undersigned,hereby state that the information pro •ed in this report is true and accurate, and that site operations are
being conducted in accordance with the Diy,�sion appy. ining and reclamation plans.
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`G(� ci7—
Signature of Per, Age' , orporate(Ayer,Owner,or Documented Designee Date
M-AF-01