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3 - • • <br />~ -5- <br />Tr.e ;,zr-nittaz is encour;.ged to contact the State Ervin=_zr, with regard to Lhe <br />dd Piiri-5:.rat:Jl1 cf wat°_r fl _hL S, antl Lhe W 1Jrdd0 i)d;id rLdent GP healtn, W1 n Yeyard t0 <br />tn~ tlischa~_e o. pollutants into use waters or" the Statz. ~'~ola*.ion or loratlo water <br />1a'n5 ~o:.ld rasult In enfOrCe",ent aLLlOns tdri2^ by Lne Matt Gnglneer dll:.'J ine CO1JfLd0 <br />Depart,n_ct c-" :xaltn. <br />AUUITIUIJAL ?"~FIJr~IvT:C:J <br />Tnis space can oe referenced for furtner information of any of the items) <br />this form <br />MINED LAND RECLAMATION DIVISION N ~ OOH G 7 <br />1313 Sherman, Room 423 ~/ <br />Denver, Colorado BO103 DATE ~B c ~ ~ <br />03) 866-3567" <br />RECEIVED FROM 1.~', -_~ ~{1 1 ~ ~rr~ I}}I'''~~'' ~~ ~ <br />THE SUM OF ~~' '^^"~'~~`~' +~XYCK1 DOLL RS $ G <br />FOR ~ ~ FY~~-b /~ <br />AMOUNT OF ACCOUNT...... $ ~~QnI_ l ' IoUI <br />AMOUNT PAID ................ $ • ~// 'JUI <br />BALANCE DUE ........ ...... $ BY <br />To t:~e oast of my knowledge, all the information presen.ed in this applifation is true <br />and correct. <br />Vate: Rovember 19. I <br />ay: <br />Alan Parkerson <br />Vir~•~^resident <br />~1Ci~ <br /> <br />UJC. ~~.. _.,~_ <br />