2019-08-29_REVISION - M1979075 ‎(3)‎

• Permit No: M1979075
• IBM Index Class Name: REVISION
• Doc Date: 8/29/2019
• Doc Name: Request For Surety Release
• From: Oldcastle SW Group
• To: DRMS
• Type & Sequence: SL1
• Email Name: ACY
• Email Name: THM
• Media Type: D
• Archive: No

In accordance with Rule 4.17.1(4), if requesting a full or partial acreage release the Operator or their
agent MUST sign that they have complied with the following statement: "All applicable portions of the
Reclamation Plan requirements have been satisfied in accordance with these Rules and all applicable
requirements under the Act."
Jason B u rkey Digitally signed Jason '0 08/22/2019
Date:2019.08.22 09:29:56-06-060'
Signature of Permittee, Operator or their authorized agent Date
Important: In accordance with Rules 4.14.2(a) and 4.17.10)This release request must be submitted
to the Division via certified mail and separate from any other correspondence to the Division.