2015-05-21_REPORT - M2014008

• Permit No: M2014008
• IBM Index Class Name: REPORT
• Doc Date: 5/21/2015
• Doc Name: Annual Report
• From: Washington County
• To: DRMS
• Email Name: ERR
• Media Type: D
• Archive: No

F2: 7-0' 'D f2�tY1 S
,"/May 21 15 10:07a Washington County 970-383-2213 p.2
2015-05-21 02:23 3038328106 3038328906 >> 970 383 2213 P 212
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Pale 3 of
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13. Is weed conirol beim 4nducted in accordance with an approved Weed Control Plan? "Y1✓5 NO /A
If "Yi:S", indic:atc: the ,*eed species, control area, control type, appl kation reitc ana treatment date on the report snap.
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14. 15 adequate topsuil rescj ved for reclam.ition, based on your approved permit? 1~S NO N!A
1f "NO", plcasc explain
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15. is the reserved topsoil t eget ted/stabilizcd in accordance with Rule 3.1.9(1)'? YESN() N/A
If "NO" please explain! X" copre S 1; It rewcw,► y Al $a;l
0a fke p;1G , i
16. If mining Las exposed groundwater, is the site in compliance with thv approved inining plan and 011X4 of the State
Engineer (Well Permit,{S.W.S_P., and/or Permancni.Augmentation Plan)? YES NQ N/
17. Are all hazardous rneterials stored within approved spill contauunent struclues? YES Nn N/A
18. Is your fmancial warranty value sufficient to cover the cast to u►mplete reclamation? 5 NO N/A
19. is your basis for legal right to enty-r still valid? YES NO
20. Does your permit requiie you to submit monitoring information annually`? YES NON/A
If "Yes", please attach the required monitorinp, results to this Annual Repot
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21- As required by Colors Mined Land Reclamation Act and/or Colorado Land Reclamation Ac:t for the Extraction of
Construction , aicrials (C.R.S_ 34-32-116 or 34-32.5-116), atwch a rnap to this report that accurately depicts the
permit. boundary, curve it affvuttx1 area boundary and loe;ation of the acrwges specified in items 7-1.2 and 14.
UPDATED MAP ATFI4CIIm ` e
Division r"ortls indicate
print current contact info
I'crmitlee Contact:
Pennitlee Company.
Addresc:
Phone Nurnbix
Fax Nutrlbzt i
following permittee contact in formatioit. If th6- it+rormation is not tsuntint, please type or
W i lliarns
Washington County
t 1920 Co. Rd. CC
PPO. I3ox 32
Anton. CO 8ORM
1) 383-2216
77) 03s-3221
Email Address: .PR.mutil
1, the undersigned, hereby Ataw that the infonmation provided ill this roPOrt iq tiue and accurate, and that site operations are
being ponducted in acc:or4ce with the Division approved raining and rechuntdon plans.
Signature of
M.nr-da
Owner, or Documented Desi nce
S z 1014—
Dal
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Dat e: