2011-11-22_PERMIT FILE - M2011054

• Permit No: M2011054
• IBM Index Class Name: PERMIT FILE
• Doc Date: 11/22/2011
• Doc Name: New 112c application
• From: Oldcastle SW Group, Inc. dba United Companies
• To: DRMS
• Email Name: THM
• Media Type: D
• Archive: No

1 I. Correspondence Information:
APPLICANT/oEE:WQ (name, address, and phone of name to be used on permit)
Contact's Name:
Company Name:
Street/P.O. Box:
City:
State:
Telephone Number:
Fax Number:
PERMITTING CONTACT
Contact's Name:
Company Name:
Street/P.O. Box:
City:
State:
Telephone Number:
Fax Number:
INSPECTION CONTACT
Contact's Name:
Company Name:
Street/P.O. Box:
City:
State:
Telephone Number:
Fax Number:
Street:
City:
State:
Telephone Number.
- 3 -
Peter J. Sle mund Vice President
9 Title: _....
Oldcastle Southwest Group, Inc. d /b /a United Companies
2273 River Road P.O. Box:
Grand Junction
Colorado Zip Code: 81502
( 970 1 .243 -4900
( 970 1. 243 -5945
(if different from applicant/operator above)
Paul Banks
Paul Banks and Associates, LLC
720 Kipling Street, Ste. 117 P.O. Box:
Lakewood
Colorado
003 1.274 -4277
( 303 - 274 -8329
(same as Applicant/Operator)
C: STATE OR FEDERAL, L40DOWNEJ (if arty)
Agency:
Street:
City:
State:
Telephone Number: L)
t'5;. ST 7/j �„' R FEDE$riLJPQWNBR (i1
Agency:
yi'tle: Manager
Zip Code: 80215
Title:
P.O. Box:
Zip Code:
J-
( 1-
Zip Code: