2014-05-13_REPORT - M1996007

• Permit No: M1996007
• IBM Index Class Name: Report
• Doc Date: 5/13/2014
• From: Colorado Department of Transportation
• To: DRMS
• Annual Report Year: 2014
• Permit Index Doc Type: Annual Fee/Report
• Email Name: RCO
• Media Type: D
• Archive: No

.Page 3 of 3
13. Is weed control being conducted in accordance with an approved Weed Control Plan? YES NO 10
If "YES ", indicate the weed species, control area, control type, application rate and treatment date on the report map.
14. Is adequate topsoil reserved for reclamation, based on your approved permit? NO N/A
If "NO ", please explain:
15. Is the reserved topsoil vegetated/stabilized in accordance with Rule 3.1.9(1)? � NO N/A
If "NO" please explain:
16. If mining has exposed groundwater, is the site in compliance with the approved mining plan and Office of the State
Engineer (Well Permit, S.W.S.P., and /or Permanent Augmentation Plan)? YES NO
17. Are all hazardous materials stored within approved spill containment structures?
YES NO
18. Is your financial warranty value sufficient to cover the cost to complete reclamation?
YES NO
f/
19. Is your basis for legal right to enter still valid?
NO
20. Does your permit require you to submit monitoring information annually?
NO
N/A
If "Yes ", please attach the required monitoring results to this Annual Report.
222 S 6th St Rm 317
21. As required by Colorado Mined Land Reclamation Act and /or Colorado Land Reclamation Act for the Extraction of
Construction Materials (C.R.S. 34 -32 -116 or 34- 32.5 -116), attach a map to this report that accurately depicts the
permit boundary, current affected a Ta youndary and location of the acreages specified in items 7- 12 and 14.
UPDATED MAP ATTACHED:
Division records indicate the following permittee contact information. If this information is not current, please type or
print current contact information:
Permittee Contact:
Jeremy Lucero
f/
Permittee Company:
Colorado Department of
Transportation
Address:
222 S 6th St Rm 317
Grand Junction, CO 81501
jCLry,� f _ �� j �1 0
Phone Number:
(970) 683 -6223
C G ` 93
Fax Number:
(970) 683 -6227
Ono / P
(� (�
Email Address:
CF.PR.email
I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are
being c. nductO it accordanc�e� w t Q�ygj %gproved mining and reclamation plans.
i hem. -..,y -� '+
her;nr ;h'i a, ve e °e +,6y ins cte weighed, counted or
�e4s uF�r� t> r ::orn orfities nd them in condition
,a.,t comply:np wit he pe f' i s given at the goods
'Id w,A x, are rac c Dance, at the services S
Signature�o er i ee ora Officer, Owner, or Documented Designee Date
r <ocieved Signature of Person accepting goods/services
Pte; o! Print Name
..i +;r. '�7 ,` — As, � Function