2004-04-19_REPORT - M1977247

• Permit No: M1977247
• IBM Index Class Name: Report
• Doc Date: 4/19/2004
• Doc Name: 2004 Annual Report
• From: Georgia-Pacific Gypsum Corporation
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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Georgia-Pacific Gypsum Corporation
M-1977-247
Coaldale Quarry
April 28, 2004
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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:

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APR ~ ~ zoos
Division of t+linerals en~lGeoloGD
$688.00 (Due on or before your anniversary date)
Fremont
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, 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 ynnr revised written annnal re, nrt and anm~al re~nrt main to this form- Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Kenneth S. Klco
Permittee Name: Georgia-Pacific Gypsum Corporation
Address: P.O. Box 338
Cotopaxi, CO 81223
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.
Signature of~oapoxat° ^~.~, or De ignee
Date