2009-09-02_REVISION - M1998022 ‎(4)‎

• Permit No: M1998022
• IBM Index Class Name: REVISION
• Doc Date: 9/2/2009
• Doc Name: Conversion application
• From: The Gallegos Corporation
• To: DRMS
• Type & Sequence: CN1
• Email Name: GRM
• Media Type: D
• Archive: No

Latitude (N) _. (5 decimal places)
Longitude(W) (5 decimal places)
OR
Universal Transverse Mercator (UTM)
Example: 201336.3 E NAD27 Zone 13
4398351.2 N
UTM Datum (specify NAD27, NAD83 or WGS 84) NAD 83 Zone 13
Easting
Northing
11. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Gary Woodworth Title: Chief Operations Officer
Company Name: The Gallegos Corporation
Street/P.O. Box: P.O. Box 821 P.O. Box:
City: Vail

State: CO Zip Code: 81658
Telephone Number: [phone] -

Fax Number: [phone] -

PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: William P. Balaz, Jr. Title: Sr. Engineer
Company Name: Tetra Tech Inc.

Street/P.O. Box: 825 North Crest Drive P.O. Box:
City: Grand Junction
State:
Telephone Number:
Fax Number:
INSPECTION CONTACT
Contact's Name:
Company Name:
Street/P.O. Box:
City:
State:
Telephone Number:
Fax Number:
CO Zip Code: 81506
[phone]
(9970) 241-3120 -
Frank Guiterrez Title: President
The Gallegos Corporation
P.O. Box 821 P.O. Box:
CO Zip Code: 81658
[phone] x105 -
[phone] -
CC: STATE OR FEDERAL LANDOWNER (if any)
office of Office of
alined land Reclamation Dwver • Grand Junction • Durango Active and Inactive Mines