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2013-01-23_REVISION - M1984076
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2013-01-23_REVISION - M1984076
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Entry Properties
Last modified
6/16/2021 6:05:30 PM
Creation date
1/23/2013 2:58:20 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1984076
IBM Index Class Name
REVISION
Doc Date
1/23/2013
Doc Name
TR-02 REQUEST
From
GENERAL SHALE
To
DRMS
Type & Sequence
TR2
Email Name
TAK
BMK
Media Type
D
Archive
No
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I AFFADAVIT <br />Per rule 1.1.20 Inert material is defined as <br />"means non - water - soluble and non - putrescible solids together with such minor amounts and types <br />of other materials, unless such materials are acid or toxic producing, as will not significantly affect <br />the inert nature of such solids. The term includes, but is not limited to, earth, sand, gravel, rock, <br />concrete which has been in a hardened state for at least sixty days, masonry, asphalt paving <br />fragments, and other inert solids." <br />I, Anthony Fabrizio , certify the following: <br />To my knowledge the scrap brick generated from General Shale Brick's Denver plant is inert and contains <br />no contaminants of any kind This material will be placed at the General Shale Brick, Inc.'s DDD Mine DWR <br />Mine as structural fill and should have no impact upon environmental conditions at the mine site. <br />Signature: <br />Date: (21 <br />L t3 <br />Subscribed and sworn to before me in the county of <br />this [ (D day of Ju MIA!" <br />LOWELL A PAINE <br />NOTARY PUBLIC <br />STATE OF COLORADO <br />NOTARY ID 20084025885 <br />MY COMMISSION EXPIRES AUGUST 10, 2018 <br />— DCA ute_47 <br />Title: Vice President Manufacturing <br />,Zd 1Y My commission expires . <br />, Colorado, <br />Notary Publi Signature <br />
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