2012-02-03_REPORT - M2005021

• Permit No: M2005021
• IBM Index Class Name: REPORT
• Doc Date: 2/3/2012
• From: Oldcastle SW Group, Inc.
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Email Name: THM
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE;
Address:
Phone Number:
Fax Number:
Permittee Contact: 1- Jason Burkey
P.O. Box 3609
Grand Junction, CO 81502
[phone]
(970) 243 -5945
Signature o
Date
orporate Officer, vner, or Designee
ANNUAL FEE and Rr.POR7
(("OldcasUe SW Group, Inc. dba United Companies of Mesa County
J/M- 2005 -021
Anderson Pit EC Ei VED
L I H I 1.
February 1, 2012
$791.00 (Due on or before your anniversary date)
PermitteeName: OIdcastle SW Group, Inc. dba United Companies
According to C.R.S. 34 or C.R.S. 34 -32 -116, each year, on the anniversary date of the permit, an operator
shall submit the annual fee, a report and map showing the- extent of current disturbances to affected land,
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report map to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated
man. If no new disturbances or reclamation have occurred during the previous year and no new changes to
the previous year's map are necessary, then no new map is required, provided that the Operator shall state
this in the Annual Report. Please note that cm adequately labeled map that clearly delineates and includes the
above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and rnake any necessary
changes:
of Mesa County
If you have additional comments and/or information that should be provided to the Division, please provide
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
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