2012-06-19_REPORT - P2010011

• Permit No: P2010011
• IBM Index Class Name: REPORT
• Doc Date: 6/19/2012
• Doc Name: ANNUAL FEE/REPORT
• From: POWERTECH
• To: DRMS
• Email Name: GRM
• Media Type: D
• Archive: No

Permittee Contact:
Richard Blubaugh
Permittee Company:
Powertech (USA) Inc.
Address:
5575 DTC Pkwy., Suite 140
Greenwood Village, CO 80111
Phone Number:
(303) 790 -7528
Fax Number:
(303) 790 -3885
Email Address:
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22. As required by rule 5.6.1(1), attach a map to this report that accurately depicts the NOI boundary, current affected
area, location of all previously listed featured, and all acreages listed in items 6 through 12 and item 20.
These activities must be identified on a site map of adequate scale to field locate these areas, and may include
coordinates in latitude and longitude to at least 5 decimal places, or UTM coordinates with the datum and zone
specified.
UPDATED MAP ATTACHED:
Division records indicate the following permittee/landowner contact information. If this information is not current, please
type or print current contact information: Rule 5.6.1(a, b).
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Page 4 of 4
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Landowner Contact:
Landowner Address:
Landowner Phone
Number:
Landowner Email
Address:
I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are
being conducted in accordance with the Division approved NOI and reclamation plans. Rule 5.6.1(h).
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Signature of Permittee Cor orate Officer, Owner or Documented Desi . Om 4#13P2-2.—