REP00039

• Permit No: M1993087
• IBM Index Class Name: Report
• Doc Date: 2/3/2004
• Doc Name: 2004 Annual Report
• From: Baca County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

l~"
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
Valco -Rocky Ford Div
M-1977-222
Rocky Ford South Pi[
January 25, 2004
RECEIVEm
""~- COUNTY:
FEB 0 4 2004
Dinisian of Minerals & Geulop-'
$688.00 (Due on or before your anniversary date)
Otero
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-1 ] 6, each year, on the anniversary date of the permit, an operator
- shall-submit the annual fee, a report and map showing the extent of current disturbances to affected land,
reclamation-accomplished-to-date-and-during-the-preceding-year,-new disturbances-that-are-anticipated-to-occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written anneal report and anneal report man to this Form. P/ease note that an
adequately labeled map that clearly delineates and includes the above elements may sz ffce,lor a wrrtten report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Wayne Adams
Permittee Name: Valco -Rocky Ford Div
Address: P. O. Box 550
Rocky Ford, CO 81067
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instmctions are enclosed.
Signature of Corporate Officer, Owner, or Designee
-~7-D
Date
M:~ PERM ITIMASTER DOCUM ENTS~M-A F01