2003-01-22_REPORT - M1977222

• Permit No: M1977222
• IBM Index Class Name: Report
• Doc Date: 1/22/2003
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNiIAi.FF.F.andRF.PnRTRF.OLT ~ECE!VED
Valco -Rocky Ford Div
M-1977-222
Rocky Ford South Pit
January 25, 2003
$688.00 (Due on or before your anniversary date)
Otero
JAN 2 2 2003
Oivisien of Minerals and Geology
According to C.R.S. 3432.5-I 16 or C.R.S. 3432-116, each yeaz, on the anniversary date of [he permit, an operator
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
-ieclamation-accomplisfied"to date and dunng the preceding year, new-distitrbances 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.
Pleats attach x,Qur revised written annual retort and annual re nn rt m~ to this form. Please note thcit an
adequately labeled map that clearly delineates and includes the above elements may sufj"rce for a written 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 instructions are enclosed.
i
./ .c.c
Signature of Corporate Officer, Owner, or Designee
~- 8 - ~.~
Dale
M:~PERMITMASTERD000MEMSU1-AF-01