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2013-06-18_REVISION - M1987164 (9)
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2013-06-18_REVISION - M1987164 (9)
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Last modified
6/15/2021 3:13:11 PM
Creation date
6/19/2013 3:48:23 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1987164
IBM Index Class Name
REVISION
Doc Date
6/18/2013
Doc Name
AM-02 APPLICATION
From
OPERATOR
To
DRMS
Type & Sequence
AM2
Email Name
DMC
GRM
Media Type
D
Archive
No
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Affidavit for Import of Materials into Hayden Gravel Pit <br />Date or Time Period of Import: <br />Description of Import Material: <br />Entity Providing Material to Pit (not the trucking Company): <br />I hereby certify that the material described above and brought to the Hayden Gravel Pit site is <br />inert, which means it is free from any chemicals, toxic substances, acid forming material, or any <br />other material which would violate the material waste disposal laws of the State of Colorado. <br />Signature <br />Written Name of Signer <br />Signer's Position in Company Company <br />Date: <br />Hayden Gravel Pit, May 2013 D -9 <br />
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