Laserfiche WebLink
xt~ J.~.F~ rr ''~FF r <br />r <br />4 ~ - <br />, <br />~_ _ STATE OF COLO ` °~.. <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: 13031 866-3567 <br />FA%:13031 832.8106 <br />AVS Annual Review <br />Inspection Worksheet <br />Date ~~ ~3 ~~ <br />Mine Name/Permit Number /' ,Y~ C' - 8/'~ d~~ <br />Iuspector Signature Y <br />Based on your ON-SITE Observation, please answer the following: <br />1) Mine ID sign <br />DIVISION OF <br />MINERALS <br />GEOLOGY <br />RECLAMATION <br />MINING•SAFETY <br />Bill Owens <br />Governor <br />Greg E. Walther <br />Executive Duector <br />Michael 6. Long <br />D~v~sion Director <br />a) Permittee ,Qlae ~oc.arizcrn E"er~y~ LKC, <br />b) Operator .t'~(,cr r ///n(i4rTG.l~t ~rle~ ~~ Lyc- <br />c) MSIIA ID ~- (not required to be on sign) <br />2) Direct inquiry (of persons oD the site) <br />a) Permittee ~~ue /~c4a/~~~. Lsie~~y Lh~. <br />b) Operator ~134c c ~~(1n ~tih ~~78~ ~~ -~~ c - <br />c) MSI3A ID Q.S -- 0.3SOS <br />3) Is ownership/control information for Permittee and operator noted in Feld consistent with <br />what is listed in the person application? Yes ~F1o <br />It No, what is in conflict? <br />DMG is required to verify this information as specified in the AV S MOU if the permitting action was <br />approved subsequently to the MOU (renewal, transfers and revisions). Annually as long as coal <br />extraction from the site has not been completed, DMG must determine whether officer/controller <br />information is complete and accurate in AVS. In making the determination of complete and accurate <br />information, on-site observations and direct inquiry of persons on the site is necessary. The information <br />on this form will be verified with AML, MSHA, and EIA information in AVS. Please return the form to <br />Johanna Cramer to be verified in the AVS. <br />