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RECEIVED <br />NOV 07 2017 <br />DIVISION OF ECLAM TION, <br />MIN RE MMP <br />(DRMS Office Use Only) <br />� e <br />110 3 T3issen Farm <br />County: <br />weld <br />Anniversary Date: Mvember 21, 201.7 <br />Current Bond Amt: 1 $547,800.00 <br />Annual Fee Due: $791.00 <br />Permit Acreage: 1 <br />DRMS Specialist f ECS <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 />I. Is the site identification sign posted in accordance with Rule 3.1.12(l)? <br />YE <br />NO <br />2. Is the affected area boundary clearly marked in accordance with Rule 3.1.12(2)? <br />NO <br />3. Is the mine site in final reclamation (all material extraction and stockpile removal is complete)? <br />YE <br />t <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 />.1J <br />5. Does the mine operate more than 180 days per year? <br />YE <br />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 />YES <br />b) approval for INTERMITTENT OPERATION? <br />YES <br />7. Number of acres currently affected (mining + incomplete and or unreleased reclamation): <br />} % <br />8. Number of acres that were newly affected during the current report year: <br />C7 <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 />f <br />11. Estimated acres to be reclaimed in the next report year: <br />Z-1> <br />