2000-03-09_GENERAL DOCUMENTS - C1981015

• Permit No: C1981015
• IBM Index Class Name: General Documents
• Doc Date: 3/9/2000
• Doc Name: PKA-0-455
• Permit Index Doc Type: Reclamation Projects
• Media Type: D
• Archive: No

f
A
Attachment B
AML CONTRACTOR
OWNERSHIP AND CONTROL DATA CERTIFICATION
Company Name: Phone-
Address : _/I ed 4?? Co g/?
Subcontractor Name: it Phone:
Address:
.
CERTIFICATION OF EXISTING DATA:
I, ntu t YYI. ?r?C being duly authorized, do hereby
certify that no changes have occurred in the existing ownership and
control data (attach printouts) listed in the Federal Office of
Surface Mining, Applicant/Violator System for the contractor
company, ,U- l l/jC-, and the subcontractor company,
3 A
Signature Title a e
ivvllrl`estlvty yr vrvrrr.x?nlr 11NU k-UD.L.KUL iJA"1"A UAA.NUt;5
The ownership and control data currently in the Federal Office of
Surface Mining, Applicant/Violator System needs to be amended in
the following ways:
Addition of information related to officers, directors,
shareholders or any other entity who owns or, controls the
contractor as defined !!in 30 CFR 773.5:
i
Name
Address
Title
Begin date End Date (attach documentation)