REV106255

• Permit No: C1981013
• IBM Index Class Name: Revision
• Doc Date: 1/7/1999
• Doc Name: REQUEST FOR AVS CHECKS
• Type & Sequence: RN3
• Media Type: D
• Archive: No

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_ Request for AVS Checks'
Permit C-_/_/_ p lication (type & #): N~~3 ~~,~,n
Applicant ?ti Y S IVISHA ID Number /"~~~
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To: AVS Reviewer
From:
Date: / / 7 /
Please conduct an AVS review of this application (adequacy stage of processing, within 30 days of
finding the application complete). Attached is a current list of the owners and controllers for the
applicant and the operators, as required by Rule 2.03.4, Identification of Interests. If applicable, a
list of permits held by the applicant in other states, by numbers and state codes, is also attached.
To: ffs~r ~ From: AVS Reviewer Date: / /
AVS Adequacy Review: Date °e /T°"/~ Recommendation rjs~ ~
OSM Recommendation': Date it /.F-/99 Recommendation Srsu ~
To: AVS Reviewer
Date: .S /10 / o`ZOOO
Please conduct an AV S review of this application for a proposed decis on (3 5 days prior).
To: ~~~ From: AVS Reviewer Date: 5 /1/I~ ~ 725- _ ~-
AVS Proposed Decision Reviev~: Date:S 11 (~/~Recommendationl~ ~~u~~icns '-('~U~
OSM Recornmendation2: Date ~/~/~ Recommendation io~ai~i~s w
To: AVS Reviewer From:
Date: _/_/_
Please conduct an AVS review of this application for a proposed issue (3-~ days prior).
To: ~~
From: AVS Reviewer Date: ~ / ~ /~
AVS Issue Review': Date: q /-I /(b Recommendation ~S~2~p
OSM Recommendation' Date/~ /(`~ Recommendation ~SS'L,~Q.
To: AVS Reviewer From: Date: / /
Pet7nit Issue date: _/ /_ .Permit Esp. Date: _/_/_ Permiaed Acres:
'Three A VS checks are required for new permit, permit revision, permit renewal, and permit transfer applications.
Copy attached.