Form ID

Publication date

Location of premises

Certificate

Mine Site Rehabilitation

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ontario Ministry of Northern Development and Mines
Address of Owner
Willet Gren Miller Ctr., Level B4, 933 Ramsey Lake Rd., Sudb
Name of Contractor
Hazco Environmental Services
Address of Contractor
Unit 1, 325 Parkdale Road, St. Andrews, Manitoba R1A 3N9
Name of Certifier
Chris Hamblin
Address of Certifier
Willet Green Miller Ctr., Level B4, 933 Ramsey Lake Rd., Sud

Office to which claim for lien must be given to preserve lien

MNDM Legal Services Branch, MacDonald Block, Rm M2-17, 900 Bay Street, Toronto, ON M7A 1C3
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