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, .:.. <br />• 1111 11111 11111111II^ • <br />Notice of Intent L~ ~~,.,... ng Operations <br />112 Annual Report - <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br />Total: <br />Broderick & Gibbons, Inc. <br />M-90-112 <br />State Pit <br />01/07/92 <br />F~~C~I~r'i~~ <br />DEC 1 8 1991 <br />Mined Land <br />RP^.lamation Di~~~~' <br />$430.00 (Due on your Anniversary Date) <br />1. Has your mine been granted TEMPORARY CESSATION STATUS? <br />Does your mine operate MORE or LESS than 180 days per year? <br />2. Total acres affected during the report year:* <br />YES NO <br />MORE LESS <br />3. Total acres reclaimed for the report year:* <br />4. Total acres in various stages of reclamation:* <br />a. Backfilled: ~_ d. Topsoil replaced: C'~ <br />b. Graded: ~ Average topsoil t ickness <br />c. Seeded: ~ replaced: N <br />List species seeded & seeding <br />rate for report year on back <br />5. The type and approximate quantity of fertilizers, organic material or soil <br />conditioners used for the report year:* /(/,rl <br />6. Estimated total acres to be affected in the next report year:' <br />7. COMMENTS: <br />* Please show the location of the acreage for items 2 - 6 on your map*`. <br />Indicate the phases of the reclamation which have been completed, correlated <br />with your timetable. <br />NOTE: If there have not been any changes since the last annual report and <br />you previously submitted a map which correctly depicts the current acreage in <br />items 2 through 6, then a new map is unnecessary. However, you must state this <br />fact above. <br />Signature: ~~~" ~~~``-"~ Date: ~~- S- 9/ <br />Please type or print current contact name, address, and phone number below: <br />Contact Name: Frank M. Gra`iam ~ Jr. Phone: 1303 > ~/a!~-/lG~ <br />Company: ,~'Q~1~zP~ Gn~/LS ~-lne~. <br />Address: 15/00 W ~f{~ ~° <br />.~T ~~a~ <br />Federal Tax ID No. or Social Security No.: t <br />