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Page 3 of'S <br />112c Annual Report <br />RECEIVEDPermittee <br />NOV n 2 2017 <br />DIVISION OF RECLAMATION, <br />MIN 1.3 <br />FE EPaR � <br />(DRMS Office Use Only) <br />Permit Number: <br />M-1981-148 <br />Name: <br />General Shale Brick, Inc. <br />Operation Name: <br />Chieftain South Mine <br />County: <br />Jefferson <br />Anniversary Date: <br />November i, 2017 <br />Current Bond Amt: <br />$315,000.00 <br />Annual Fee Due: <br />$791.00 <br />Permit Acreage: <br />DRMS Specialist <br />98. <br />A <br />According to C.R.S. 34-32.5-116 or 34-32-116, each year, on the anniversary date of the permit, an operator shall submit <br />the Annual Fee, an Annual Report and Map showing the extent of current disturbances to affected land, required monitoring <br />information, reclamation accomplished to date and during the preceding year, any new disturbance that is anticipated to <br />occur during the upcoming year, any reclamation that will be performed during the upcoming year, the dates for the <br />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(1)? 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 <br />If "YES," please note time limits related to completion of reclamation, Rule 3.1.3. �D <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? <br />b) approval for INTERMITTENT OPERATION? <br />7. Number of acres currently affected (mining f 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 />YES <br />YES NO <br />5 . <br />