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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2004009 <br />Asphalt Specialties Co. <br />Receipt #: <br />Date: <br />8734 <br />08/04/2010 <br />M2004009 <br />Permit: <br />000000000 <br />15993 14300-01 1 Minerals Annual Fees <br />M-2004-009 <br />$791.00 <br />Receipt Total: $791.00 <br />Page 1 of 1