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Page 3 of 3 <br /> 13. Is weed control being conducted in accordance with an approved Weed Control Plan? 'ES NO N/A <br /> If"YES", indicate the weed species, control area, control type, application rate and treatment <br /> on 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)? NO N/A <br /> If"NO"please explain: (�S) <br /> 16. If mining has exposed groundwater, is the site in compliance with the approved mining plan and Office of the <br /> Engineer(Well Permit, S.W.S.P.,and/or Permanent Augmentation Plan)? YES NO N/A <br /> 17. Are all hazardous materials stored within approved spill containment structures? YES NO N <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? Y NO N/A <br /> If"Yes",please attach the required monitoring results to this Annual Report. <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: <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: / , p <br /> Permittee Company: Medicine Bow-Routt National <br /> Forest USDA Forest Service <br /> Address: 2468 Jackson St. <br /> Laramie, WY 82070-6535 <br /> Phone Number: 3 \ 7 ys_ �y 3 6 <br /> Fax Number: (307)745-2398 <br /> Email Address: CF.PR.email l/ <br /> �a�r�w �.c <br /> 1,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 /> Z/;��- P� -7a11—/,W <br /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date <br />