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RECEIVED <br /> DEC 0 8 2015 Pace 3 o1'5 <br /> D 8100N OF RECLAMATIO <br /> )or( <br /> Permittee Name: Chevron Shale Oil Permit Number: M-2000 39 <br /> Company,a division of <br /> Chevron USA, Inc. _ <br /> Operation Name: North Clear Creek County: Garfield <br /> Construction Materials <br /> Mine <br /> Annual Fee Due: $323.00 _Anniversary Date: _ Decemb Dr 800 <br /> Permit Acreage: 8.00 Current Bond Amt: $36,939 00 <br /> According to C.R.S.34-32.5-116 or 34-32-116,each year,on the anniversary date of the hermit, an operator shall submit <br /> the Annual Fee,an Annual Report and Map showing the extent 01'CUrrent disturbances to affected land,required <br /> monitoring information,reclamation accomplished to date and during the preceding year, any new disturbance that is <br /> anticipated to occur during the upcoming year, any reclamation that will be perfornied during the upcoming year,the <br /> dates for the beginning of active operations,and the date active operations ceased fort a year. <br /> Information contained in this report will be reviewed by the Division upon receipt and prior to the next compliance <br /> inspection of the site. If,while completing this report,you learn that your site is not in compliance with the rules and the <br /> act,it is advisable that the issues be rectified promptly to avoid possible enforcement action. <br /> 1. Is the site identification sign posted in accordance with Rule 3.1.12(l). Y1:S NO <br /> 2. Is the affected area boundary clearly marked in accordance with Rule 3.1.12(2). YI=S NO <br /> 3. Is the mine site in final reclamation (all material extraction and stockpile removal s complete)? YI-S <br /> If"YES,"please note time limits related to completion of reclamation, Rule 3.1.3 <br /> 4. What was the date of last excavation,processing or hauling activity at the mine? 1IL12 �3 <br /> 5. Does the mine operate more than 180 days per year? YES NO <br /> if"NO",please review Rule 1.13 to assure that your mine is in compliance. <br /> 6. Has this mine been granted: a)approval of TEMPORARY CESSATION Statu <br /> b)approval for INTERMITTENT OPERATION? 1' .., NO <br /> 7. Number of acres currently affected(mining— incomplete and or unreleased reclamation). L ID <br /> K. Number of acres that were newly affected during the current report year. O <br /> 9. Number of acres that were reclaimed during the current report year. <br /> 10. Estimated new acreage to be affected in the next report year. 0 <br /> 11. Estimated acres to be reclaimed in the next report year. <br /> 12. Total acres in various sta es of reclamation,since pert itted mining activities began: <br /> Total acres Total acres Total acres Total acres <br /> backfilled: U seeded w/ 5 w/topsoil d mulched w/ <br /> approved mix: replaced: approved mulch: <br /> Total acres Total acres Topsoil Mulch application <br /> graded: v fertilized w/ 0 replacement rate(tons/ac): <br /> a vd fertilizer: depth(in.): AjA, <br />