2006-01-12_REPORT - M1977222

• Permit No: M1977222
• IBM Index Class Name: Report
• Doc Date: 1/12/2006
• Doc Name: Annual Fee/Report/Map
• From: Valco - Rocky Ford Div.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
RECEIVED
JAN 1 11D06
ANNiTAi. FF.F. and RF.PnRT RFOiTFST Oiyision u, iytu,eraES and Geology
Valco -Rocky Ford Div
M-1977-222
Rocky Ford South Pit
January 25, 2006
$688.00 (Due on or before your anniversary date)
Otero
According to C.R.S. 34-32.5-1 I6 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 ]and, -
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 re,~prt and anneal report mad to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Petmittee Contact: Wayne Adams
Permittee Name: Valco -Rocky Ford Div
Address: P.O. Box 550
Rocky Ford, CO 81067
Phone Number: [phone]
Fax Number: [phone]
~-~1?r~ ~.. ~2arSo/l
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 Corl orate Officer, Owner, or Designee

Date