2016-01-21_REPORT - M2002109

• Permit No: M2002109
• IBM Index Class Name: Report
• Doc Date: 1/21/2016
• Doc Name: Annual Fee/Report/Map
• From: A. Blasi & Son Trucking
• To: DRMS
• Annual Report Year: 2016
• Media Type: D
• Archive: No

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13. Is weed control being conducted in accordance with an approved Weed Control Plan? YJ.F-'NO NIA
If "YES", indicate the weed species, control area, control type, application rate and treatment ate on the report map.
14. Is adequate topsoil reserved for reclamation, based on your approved permit? NO NIA
If "NO", please explain:
15. Is the reserved topsoil vegetated/stabilized in accordance with Rule 3.1.9(1)? YDS11�NO NIA
If "NO" please explain:
16. If mining has exposed groundwater, is the site in compliance with the approved mining plan and Of ce of the State
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 area boundary and location of the acreages specified in items 7- 12 and 14.
UPDATED MAP ATTACHED:
Engineer (Well Permit, S.W.S.P., and/or Permanent Augmentation Plan)? NO NIA
17. Are all hazardous materials stored within approved spill containanent structures? YES NO
18. Is your financial warranty value sufficient to cover the cast to complete reclamation? Y� NO NIA
19. Is your basis for legal right to enter still valid? Y NO
20. Does your permit require you to summit monitoring information annually? YES >011 N/A
Division records indicate the following permittee contact information. If this information is not current, please type or
print current contact information:
Permittee Contact:
Anthony Blasi
Permittee Company:
A. Blasi & Son Trucking &
Earthmoving, Inc.
Address:
38043 CR 32.4
Trinidad, CO 81082
Phone Number:
[phone]
Fax Number:
If "Yes", please attach the required monitoring results to this Annual Report.
CF.PR.email
Division records indicate the following permittee contact information. If this information is not current, please type or
print current contact information:
Permittee Contact:
Anthony Blasi
Permittee Company:
A. Blasi & Son Trucking &
Earthmoving, Inc.
Address:
38043 CR 32.4
Trinidad, CO 81082
Phone Number:
[phone]
Fax Number:
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 conducted in accordance with the Division approved mining and reclamation plans.
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Date