REP21911

• Permit No: M1997064
• IBM Index Class Name: Report
• Doc Date: 7/9/2002
• Doc Name: 2002 Annual Report
• From: Western Nutrients Inc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Western Nutrients, Inc.
M-1997-064
Agri-Cat #1
July 9, 2002
RECEIVED
JUL 0 9 2002
Division of Minerals and Geology
$225.00 (Due on or before your anniversary date)
Fremont
According to C.R.S. 34-32.5-116 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 disrurbances to affected
land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to
occur during [he upcoming year, reclamation that will be performed during the coming year, the dates for [he
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 farm. Please note that an
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 make any necessary
changes:
Permittee Contact: Jerry Screws
Permittee Name: Western Nutrients, Inc.
Address; 11157 W. 76 Place
Arvada, CO 80005
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below ar attach it to [his form along with your written report and map. Annual Report instructions are
enclosed.
Signature of Corporate Officer or Owner
Date
M9PERMI7IMASTERD000MEMSlM-AF-02 DOC