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wow Species ----9 C41%AP4TNtSTYE, 20re-00 TNISTLC', M -6k rill 577e <br />Go►k+TRov Ak-04 � SPwr- sPRM/1M& p LAR.m I– 4 RcA. <br />Cof -nlsoL 7YPe �9 $DoT SPeAYl1wG MIIeSTOr.+C IqL- Mb IGIA�'Aoub Sur— FAcT*kir Page 3of3 <br />APPLIC -*110 j9!Ar& –V S r'I.V10 ovti+czs PM ACAC ust-& Mice srowE <br />7ibc- *ry"ovT p�ATes --ap MAY g*, Zol' j ocross'`12 10,t4 2V13 <br />13. Is weed control being conducted in accordance with an approved Weed Control Plan? >T NO N/A <br />If "YES ", indicate the weed species, control area, control type, application rate and treatment date on the report map. <br />14. Is adequate topsoil reserved for reclamation, based on your approved permit? NO N/A <br />If "NO ", please explain: <br />15. Is the reserved topsoil vegetated/stabilized in accordance with Rule 3.1.9(1)? S NO N/A <br />If "NO" please explain: <br />16. If mining has exposed groundwater, is the site in compliance with the approved mining plan and Office of the S� <br />21. As required by Colorado Mined Land Reclamation Act and/or Colorado Land Reclamation Act for the Extraction of <br />Construction Materials (C.R.S. 34 -32 -116 or 34- 32.5 -116), attach a map to this report that accurately depicts the <br />permit boundary, current affected area boundary and location of the acreages specified in items 7- 12 and 14. <br />UPDATED MAP ATTACHED: 'C <br />Engineer (Well Permit, S.W.S.P., and/or Permanent Augmentation Plan)? YES NO /A <br />17. Are all hazardous materials stored within approved spill containment structures? YES NO /A <br />18. Is your financial warranty value sufficient to cover the cost to complete reclamation? � NO N/A <br />19. Is your basis for legal right to enter still valid? � NO <br />20. Does your permit require you to submit monitoring information annually? YES � N/A <br />If "Yes ", please attach the required monitoring results to this Annual Report <br />Division records indicate the following permittee contact information. If this information is not current, please type or <br />print current contact information: <br />Permittee Contact: <br />Joseph C. Welte <br />Permittee Company: <br />Summit Brick & Tile Co. <br />Address: <br />P.O. Box 533 <br />Pueblo, CO 81002 -0533 <br />Phone Number: <br />(719) 542 -8278 <br />Fax Number: <br />(719) 542 -5243 <br />Email Address: <br />CF.PR.email <br />. <br />Division records indicate the following permittee contact information. If this information is not current, please type or <br />print current contact information: <br />Permittee Contact: <br />Joseph C. Welte <br />Permittee Company: <br />Summit Brick & Tile Co. <br />Address: <br />P.O. Box 533 <br />Pueblo, CO 81002 -0533 <br />Phone Number: <br />(719) 542 -8278 <br />Fax Number: <br />(719) 542 -5243 <br />Email Address: <br />CF.PR.email <br />I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are <br />being conducted in accordance with the Division approved mining and reclamation plans. <br />%I/ 1• <br />of Permittee, Corporate Officer, Owner, or Documented Designee <br />/Z 9 z�/3 <br />Date <br />