2017-11-13_REPORT - M1996082

• Permit No: M1996082
• IBM Index Class Name: Report
• Doc Date: 11/13/2017
• Doc Name: Annual Fee/Report/Map
• From: Oldcastle Sw Group, Inc. dba United Companies of Mesa County
• To: DRMS
• Annual Report Year: 2017
• Email Name: THM
• Media Type: D
• Archive: No

Page3 ons
Division records indicate The following persrutteellandownercontact information (blank fields indicate that we do notliave
infomiation on record). If this information is blank or not current, please type or printer contact iinfonnatiou:
I kiM73z i11!e4: I
1, 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
or Documented Desisnee
1J11.6 117
Date
�mtei,'Corrnpari�es �7t�
Civ _
2273 River Road
Grand Junction, CO 81502
Address_
Phone Number:
(970) 2434900
Fax Number:
Email Address:
[e-mail]
Permitting Contact:
Jason Burkey
Company;
Oldcastle SW Group, Inc. dba
United Companies of Mesa
Count
Address:
2273 River Road
Grand Junction, CO 81502
Phone Number:
(970) 2434900
Fax Number:
Email Address:
[e-mail]
Inspection Contact:
Jason Burkey
Company:
Oldcastle SW Group, Inc. dba
United Companies of Mesa
Count
Address:
2273 River Road
Grand Junction, CO 81502
Phone Number:
(970) 2434900
Fax Number:
Email Address:
Jburkey aoldcastlematerials.com
1, 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
or Documented Desisnee
1J11.6 117
Date