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Page 3 of 3 <br />13. Is weed control being conducted in accordance with an approved Weed Control Plan? YES NO /A <br />If "YES ", indicate the weed species, control area, control type, application rate and treatment date on the repo map. <br />14. Is adequate topsoil reserved for reclamation, based on your approved permit? YES NO N/A <br />If "NO ", please explain: <br />15. Is the reserved topsoil vegetated/stabilized in accordance with Rule 3.1.9(l)? YES NO /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 to <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 <br />18. Is your financial warranty value sufficient to cover the cost to complete reclamation? YES NO CN/D <br />19. Is your basis for legal right to enter still valid? Y NO <br />20. Does your permit require you to submit monitoring information annually? YES NO 4�) <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: <br />Dean Goss <br />Permittee Company: <br />David Goss <br />Address: <br />24040 Falcon Hwy <br />Calhan, CO 80808 -9156 <br />Phone Number: <br />(719) 683 -4295 <br />Fax Number: <br />(719) 683 -2645 <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 />Signature of Permittee, Corporate Officer, Owner, or Documented Designee <br />Date <br />