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Page 2 0 F3 <br /> 110c Annual Report <br /> Permittee Name: Medicine Bow-Routt National Forest Permit Number: M-2000-040 <br /> USDA Forest Service <br /> Operation Name: State Line Ranch Pit County: Jackson <br /> Annual Fee Due: $323.00 Anniversary Date: June 23,2015 <br /> Permit Acreage: 7.00 Current Bond Amt: $0.00 <br /> According to C.R.S. 34-32.5-116 or 34-32-116, each year, on the anniversary date of the pennit, an operator shall submi <br /> the Annual Fee, an Annual Report and map showing the extent of 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 performed during the upcoming year,the <br /> dates for the beginning of active operations, and the date active operations ceased for the 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). YES NO <br /> 2. Is the affected area boundary clearly marked in accordance with Rule 3.1.12(2). YES NO <br /> 3. Is the mine site in final reclamation(all material extraction and stockpile removal is complete)? YES NO <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? <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 Status? YES NO <br /> b) approval for INTERMITTENT OPERATION? YES NO <br /> 7. Number of acres currently affected(mining+incomplete and or unreleased reclamation). <br /> 8. Number of acres that were newly affected during the current report year. <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. <br /> 11. Estimated acres to be reclaimed in the next report year. <br /> 12. Total acres in various stages of reclamation, since permitted mining activities began: <br /> Total acres Total acres Total acres TotHacres <br /> backfilled: seeded w/ w/topsoil mulapproved mix: replaced: appTotal acres Total acres Topsoil Mugraded: fertilized w/ replacement rate <br /> apvd fertilizer: depth(in.): <br /> Seed Fertilizer Mulch <br /> application application application <br /> method: method: method: <br />