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(DAMS Office Use Only) <br />operation Name: <br />County: <br />Anniversary Date: <br />Current Bond Amt: <br />ABaual Fee Due: <br />Permit Acreage: <br />DRMS Svecialict <br />16, 2017 <br />According to C.R.S. 34-32.5-116 or 34-32-116, each year, on the anniversary <br />the Annual Fee, an Annual Report and Map showingthe extent of current disturbances bance toof haffected land, <br />information, reclamation accomplished to date and during the preceding Permit, an operator shall submit <br />occur during the upcoming required monitoring <br />year, any reclamation that will be performed during new disturbance that is anticipated to <br />beginning of active operations, and the date active operations ceased for the year. the upcoming year, the dates for the <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 />I. Is the site identification sign posted in accordance with Rule 3.1.12(1)? <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)? S 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 />S. Does the mine operate more than 180 days per year? <br />If "NO", please review Rule 1.13 to assure that your mine is in compliance. TES NO <br />6. Has this mine been granted: a) approval of TEMPORARY CESSATION Statusrql <br />b) approval for INTERMITTENT OPERATION? V � YES N <br />7. Number of acres currently affected (mining + incomplete and or unreleased reclamation): YE O <br />S. 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 />OL" jj��-20gW13. <br />