WV office of Miners / Peach Court / U.S. Securities and Exchange Commission / Division of Labor / Comprehensive Mine Safety Program Anniversary Date LOOKBLOCK Workers’ Compensation Compliance Bureau of Employment Programs Compliance Complete / West Virginia office of Miners / WVMHST Regional Office / /
Person
Eugene White / Earl Ray Tomblin / / /
Position
GENERAL INFORMATION FORM Select Type / Underground Mine Surface Mine Underground Production Contractor Surface Production Contractor / Miner / Foreman / please complete General Information Form / Assessment Contact Officer / Company Official / officer / Superintendent / company officer / corporate officer / general information form / Governor / director / director / together with / Director EEW December / Representative / Production Contractor / Director EEW / /
State of West Virginia Earl Ray Tomblin , Governor W V O f f i c e of M i n e r s ’ H e al t h, S a f e t y & T r ai n i ng E ug e n e W hi t e , D i r e c t o r #7 Players Club Drive – Suite 2 Charleston, WV[removed]