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(Please be as specific as possible) <br />Note: Please provide as much detail related to location and issue as possible. Without enough detail, DRMS will not be <br />able to process or investigate the complaint and, therefore, DRMS will have no choice but to discard the complaint. <br />Location of Concern * <br />Please provide as much detail as possible. It is important to narrow down the location. If available, please include Township, Range <br />and Section, physical address, or GPS location. You may also upload a pdf map below. <br />T09 -R78 -S17 <br />Incident County <br />Park County <br />Is this an ongoing issue(s)? <br />r Yes r No <br />Nature of Complaint <br />Select all that apply <br />W Illegal Mining <br />W Ground Water / Water Well Impact <br />W Surface Water Impact / Stormwater Management <br />W Mine Plan Compliance <br />r Signs and Markers <br />W Financial Warranty <br />r Processing Waste / Tailings <br />F Fish / Wildlife <br />r Off -Site Damage <br />r Explosives / Blasting <br />W Revegetation <br />W Reclamation Plan Compliance <br />Detailed description of the issue(s) * (') <br />r Dust <br />F Acid or Toxic Materials/Spills <br />r% Property Damage <br />r Waste Management / Dumping <br />r Overburden / Development Waste <br />r% Backfilling and Grading <br />r Processing Facilities <br />r Erosion / Sedimentation <br />F Roads <br />r Topsoil <br />F Weeds <br />F Other <br />Please provide as much detail as possible. It is important to narrow down the issue(s). <br />Mining without a permit or stormwater management plan <br />Have you contacted the operator or party conducting the operation? If yes, please provide details. <br />r Yes r No <br />If known, please provide the name of the operator or party conducting the operation. <br />Mark Mayor <br />If known, please provide the Permit or NOI Number (ie M1970111 or P1970111). <br />Must be entered in the following format: M1970111 or P1970111 (No dashes allowed) <br />Have you contacted any other agencies or local governments related to this issue or issues? If so, <br />please provide details. * <br />r Yes r No <br />ADDITIONAL INFORMATION <br />Are there supporting photos, maps, or documents you wish to upload? * <br />r Yes r No <br />What is your preferred method for DRMS to communicate with you throughout the investigation? * <br />Select all that apply <br />W Phone W E-mail r US Mail <br />