2017-12-05_REPORT - M1983175

• Permit No: M1983175
• IBM Index Class Name: REPORT
• Doc Date: 12/5/2017
• Doc Name: Annual Fee/Report/Map
• From: Southwest Ready-Mix
• To: DRMS
• Annual Report Year: 2017
• Email Name: SJM
• Media Type: D
• Archive: No

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information on record). If this information is blank or not current,please type or print current contact information:
Permittee Contact Ralph Marta=
Permittee Company: Southwest Ready-Mix, Inc.
Address: 117 White Pine Dr.
Alamosa, CO 81101
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact: Joe Gagliano
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Company: L J Development, Inc.
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Address: 653 E Enterprise Dr.,Unit A
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Pueblo,CO 81007-4422 I
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
Inspection Contact: John Sliman '
Company: Southwest Ready-Mix Inc
Address: 37400 Hwy 96 East / GCJ h t ram- J�t v� ,(�Y,
Pueblo,CO 81006
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Phone Number: [phone]
Fax Number: [phone]
Email Address:
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.
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Signature 81f Permittee Cor hrde Officer,Owner,or Documented Designee Date
M-AF-01