1994-01-05_REVISION - M1985212

• Permit No: M1985212
• IBM Index Class Name: Revision
• Doc Date: 1/5/1994
• Doc Name: REGULAR OPERATION 112 RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: AM2
• Media Type: D
• Archive: No

2
9. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used o permit)
Individual 's Name: dell CCVLAr h
Company Name: q r k S o ('or IM
Street: SEZ'l S AlC. P- a 7
City: loue d
State: C016 Zip Code: DS 8
Area Code: Telephone: Co 3
PERMITTING CONTACT (if different from applicant/operator above)
Individual ' s Name: Ca U Q
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
INSPECTION CONTACT
Individual ' s Name: r i C h
Company Name: r C R h C C )I ro IH
Street: SCI 9 S E r It-
City: o 2 I q D u
State: Cold Zip Code: CS
Area Code: 3 O Telephone: n , - 1clob
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency: AlOMP
Street:
City:
State: Zip Code:
Area Code: Telephone:
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency: D C
Street:
City:
State: Zip Code:
Area Code: Telephone: