2018-01-26_REPORT - M2000103

• Permit No: M2000103
• IBM Index Class Name: REPORT
• Doc Date: 1/26/2018
• Doc Name Note: Invalid 2018 Annual Report Submission
• From: DRMS
• To: Allen P. Small
• Email Name: LJW
• Email Name: GRM
• Media Type: D
• Archive: No

Page 5 of 5
'on records indicate the following permitteeibndowner contact information(blank fields indicate that we do not have
orma-on on record). If this information is.blank or not current,please type or print current contact information:
Perni ttee Contact: Allen P.Small
' Permittee Company: Allen P Small Trucking&
Excavation,Inc.
Address: 2510 W.3rd Ave.
Durango,CO 81301
Phone Number: [phone]
Fax Number:
Email Address:
Periling Contact: Kirk Allen
Company: Southwest Land Services,Inc.
Address: 8421/2 Main Ave.
P.O.Box 2673
Durango,CO 81301
Phone Number. [phone]
Fax Number: [phone]
Email Address:
Inspection Contact: Allen P.Small
Company: Allen P.Small Tr ucking&
Excavation,Inc.
Address: 2510 W 3rd Ave
Durango,CO 81301
Phone Number: [phone]
Fax Number: [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.
i
!Irtare of Permittm Coraorate Officer,Owner.or Documented Desimee Date
M AF41