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III IIIIIIIIIIIIIIII <br />999 <br />DEPARTMENT OF NATURAL RESOURCES <br />David H. Getches. Executive Director <br />MINED LAND RECLAMATION DIVISION <br />DAVID C. SHELTO N, Director <br />Richartl D. Lamm <br />Governor <br />INSPECTION BASED UPON CITIZEN REQUEST <br />This form is to be used to track a citizen complaint received by the Division <br />pursuant to Rule 5.02.5. ~ ~ /J <br />Citizen (may remain confidential ): l;o-,; .;~.fl(-Em,/~~ <br />Date(s) request received by Division: <br />Written* <br />Oral ~yl ~,ct ~ of , / y ~ St <br />TDN ~~ <br />~4ine where a violation is alleged: ZJ;g4T,,,,r, ~~ yc~,~ r~~ <br />Division follow-up dates: <br />Citizen Notification of Inspection <br />Inspection <br />NOV <br />Written Response* <br />Citizen Appeal of Division response: <br />Date of Administrator Response: <br />Comments: <br />*P.equired <br />03-86 <br />7877E <br />Yes No <br />423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. (303) 866-3567 <br />