2005-07-11_REPORT - M1979206

• Permit No: M1979206
• IBM Index Class Name: Report
• Doc Date: 7/11/2005
• Doc Name: Annual Fee/Report/Map
• From: u s soil conditioning company
• To: dmg
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
U S Soil Conditioning Company
M-1979-206
Maverick Placer
June 16, 2005
$688.00 (Due on or before your anniversary date)
Fremont
R6~C~li/~®
JUL 1 9 1005
Division of Minerals and Geology
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date o_Fthe permit, an operator
shall submit the annual fee, a report and map showing the extent of current disturb~mces 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 ann ral r .Qnrt and annual rr.,n~nrf map to this fnrrp, Please note that an
adequately labeled map that clearly delineates and includes the above elements may Buff+ce for a written report.
Division records indicate the following permittee contact information. Please verify ar.,d make any necessary
changes:
Permittee Contact: Joseph E. Lionelle
Permittee Name: U S Soil Conditioning Company
Address: P.O. Box 926
Phone Number:
Fax Number:
Salida, CO 81201
[phone]
[phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it~o this form along with your written report and map. Annual Report instructions are enclosed.
of Corporate Officer, Owner, or Designee
4WYlLlIO ~ OOS
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