2002-11-05_REVISION - M1983176

• Permit No: M1983176
• IBM Index Class Name: Revision
• Doc Date: 11/5/2002
• Doc Name: Amendment Application
• From: Asphalt Specialties Co Inc
• To: DMG
• Type & Sequence: AM2
• Media Type: D
• Archive: No

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14. Cottesoondence InCormatioe:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contacts Name: ~7 ni B~ V~. ~ LLf1t ,~tt Title: PrE5if~~J1 `
company Name: ASpho~tSoECiQltieS(_.Ofl,mn~sn'L.
Street: -1321 E . ~3'~ /ode. ~SuifE I(~
cis: Nender~n
State: CO~O~QdO Zip Code: 8~t7
Telephone Number: ~~- Zgq-8555
Fax Number: ( 303 I - 2PA^ 7707
PERMITTING CONTACT (if different from applicant/operator above) , ~I -
Contact's Name: ~- 6 t-G I Yd Title: ~n~ ~ fIQQP t'
Company Name: 5o m G
Street:
City.
State:
Telephone Number: ( ) -
FaxNumber: I 1-
INSPECTION CONTACT
Code:
Contact's Name: ~b LdtY'd Title:
Company Name:
Street:
City.
State:
Telephone Number: ( 1-
FaxNumber: f )-
CC: STATE OR FEDERAL LANDOWNER (if anv)
Zip Code:
Agency. N. A .
Street:
City.
State:
Telephone Number: ( I -
Zip Code:
CC: STATE OR FEDERAL LANDOWNER (if any
Agency. rl. A.
street:
city.
State:
Zip Code:
Telephone Number: ( 1-