2010-09-10_REVISION - M2002094

• Permit No: M2002094
• IBM Index Class Name: REVISION
• Doc Date: 9/10/2010
• Doc Name: Inadequate Submittal of Operators Application and Performance Warranty
• From: DRMS
• To: Oldcastle SW Group, Inc. dba United Companies
• Email Name: GRM
• Media Type: D
• Archive: No

-2-
II. ADMINISTRATIVE INFORMATION:
1. Permit Number:
M-.2002 - o
2. Operation Name:
3. Current Permitted Operator:
Contact Person:
Company Name:
Street:
City:
State:
Area Code:
4. Successor Operator:
Contact Person:
Company Name:
Street:
City:
State:
Area Code:
IRS Tax ID No. or Social Security No.:
Amon P, f-
Davi ?cree-
Grgve/
P, o. 13vx 36v
' lilccGi O
C-?d Zip Code: 7
6170 Telephone: 663 _ 5-712
Oldcustle- <VV G m?l? /j
LLB;fed ?Or?-tf
-2,-2 7 3 Ri oe2 kDaZ
z'fr" d Vl' ?c-T;Oh
C O Zip Code:
970 Telephone: -?2y 3 - 73bg

5. Application Fee: $115.00 for Hard Rock operations; $144.00 for Construction Materials operations
Make check payable to the Division of Reclamation, Mining and Safety