2011-10-06_PERMIT FILE - M2011014

• Permit No: M2011014
• IBM Index Class Name: PERMIT FILE
• Doc Date: 10/6/2011
• Doc Name: Submittal of 110c application
• From: Wasteline, Inc. for Dale and Ellen Schmidt
• To: DRMS
• Email Name: KAP
• Media Type: D
• Archive: No

11. Correspondence Information:
i t . APPLICANT /OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Dale Schmidt Title:
Company Name: Dale and Ellen Schmidt (not a company)
Street/P.O. Box: 472 Meadows Drive P.O. Box:
City: Pagosa Springs
State: Colorado Zip Code: 81147
Telephone Number: ( 970 ) _ 946 - 6262
Fax Number: ( ) -
PERMITTING CONTACT (if different from applicant /operator above)
Contact's Name: Nathan A. Barton, CE, PE, DEE Title: Environmental Engineer
Company Name: WASTELINE, INC.
Street /P.O. Box: P.O. Box: 88
City: Cortez
State: Colorado Zip Code: 81321 -0088
Telephone Number: ( 605 ) - 348 -0244 or 970 - 564 -1380
Fax Number: ( ) _ E -mail: Wasteline6 @aol.com
INSPECTION CONTACT
Contact's Name: Same as above Title:
Company Name:
Street /P.O. Box: P.O. Box:
City:
State: Zip Code:
Telephone Number: ( ) -
Fax Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if any)
None
- 2 -
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency: None
Street:
City:
State: Zip Code:
Telephone Number: ( )
P3