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!, <br />PUBLIC REVIEW INFORMATION <br />Please provide the following information for our files. Thank You. <br />Date: r~~~ 9 ~ ! ~ S <br />Your Name: (rrincea> ~' <br />1~.~'1'h ''/er~,~r f,~~rs~ <br />Company Name: d iy ~~ ~/af~• /Z r~ o u ~ L e l <br />Address: <br />Files to Review: Permit Number Operator/Company Name <br /> <br />Reason for Review; <br />Phone Number: File Returaed:mMC ~.,a:..) <br />Copies Requested: Payment: <br />We hope that your recent contact with the Division of Minerals and Geology was satisfactory and was <br />perforated in a couReous and professional manner. <br />We would sincerely appreciate hearing from you about your experience in our offices or with staff <br />from the DMG in [he space provided below. Any comments or suggestions will make it possible for <br />us to serve you better. Thank You. <br />Mike Long <br />Division Director <br />Comments and/or suggestions: (For example: favorable/unfavorable regarding Divisiou forms, <br />information, procedures, service, etc.) <br />DATE: c:~~s~~nmz.r,m <br />