REV88866

• Permit No: M1977193
• IBM Index Class Name: Revision
• Doc Date: 4/4/1995
• Doc Name: RECEIPT
• From: DMG
• To: TEZAH HEAVY EQUIPMENT CO INC
• Type & Sequence: AM2
• Media Type: D
• Archive: No

10. Correspondence information:
APPLICANT/OPERATOR (same, address, and phone of acme to be used on permit)
Contact's Name: Edward J. Tezak Jr. Title: President
Company Name: Tezak Heavy Equipment Co., Inc.
Street: 904 Hwy 115
City: Penrose
State: Colorado Zip Code: 8140
Area Code: 719 Telephone: [phone]
PERMITTING CONTACT (i£ different Pram a 1lcant/operator above)
Individual' a Name: ~S ~'-~-o . Cnwsu~•w5 G'touY.~y'1
Company Name : -A'Z_v.~±~+¢ LNG
Street: ~ '~'i~
~
City: /~
l oCnQA.-n(1
c
State: C-6 Zip Coda: -~51zL3
Area Code: ~1~ Telephone: '>k2'q'(~'9
INSPECTION CONTACT
Individual's Name: Edward J. Tezak Jr. (per above)
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
CC: STATE OR FEDERAL LANDOWNER (if ax+v)
. Agency: KP
Street:
City:
State: Zip Code:
Area Code: Telephone:
CC: STATE OR FEDERAL LANDOWNER (if arrvl
Agency: ~A
Street:
City:
State: Zip Code:
Area Code: Telephone:
11. Primary future (Poet-mining) land use (check one):
_ CropTand(CR) _ Pastureland(PL) General Agriculture(G)~)
_vRangeland(RL) Forestry (FR) _ Wildlife Habitat(WL) ,
sidential(RS) _ Recreation (RC) industrial/Co~lercial~~IC)
_ Developed Water Resources (WR) _ Solid Waste Disposal (iiD)
12. Primary resent land use (check one):
_ Crop and(CR) _ Paetureland(PL) _ General Agriculture(G7~)
_Wtanyeland(RL) _ FOrestry(FR) _ Wildlife Habitat(WL)
Reaidential(RS) Recreation(RC) _ Industrial/Cammercial;IC)
_ Developed Water Reaources(WR)
13. Method of Mining: }L Quarry (QR) _ Solution (SO)
13.1 Other: Briefly explain mining method (e.g. Placer, truck/shove].).
^rill anA Rlact virh FFT. faaA to Cnichor rirrnita hi~ aw t.-u rkc haul nff-S1Ce
14. On Site Proceseina: HA Solution (SO) Chemical (CH) __ Thermal (TH)
_ Hesp Leach (HL) _ Vat Leach (VL)
List any designated chemicals or acid-producing materials to be used or etoreii within permit
Brea: NA