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,; ~:~:. <br />~„w <br />\\~l'.\I. Ff E;and REPORT RF(ft'F_til' <br />PI:RAtII I I h NA\tl, - Bueklen Equipmcnt ('ompun~ <br />I'CItA111 \u.: \1-IV8:-1Jt <br />OPI It,11 Il)\ NA~9F. Bueklen Equipmcnt ('u <br />1\\I1'I R1AR\' U,\II : ~eptember:11,211116 <br />\\ \I •\I III I tl I ~G88.1111 (1)uc on or heforc your anniversary datel <br />CUl \ I 1 \\ cld <br />^Fi~ir;~ <br />.P i a zoos <br />,n n1 P••~' ~..~ iLnn. <br />•\ccording to ( R.\. ~•1-?'.~-I 16 or l .K.ti i•7-i'-I I h, rash year. on the:umivcrzaq date of the pcnnit.:m operator <br />.hall cuhnut the ;unmal fee, a relxm and Wrap shooing Ihr extent of current di,utrb:utcc. to :tflcctud land. <br />rcclmnatinn ,icannl,l~ trd to date and during the prccaling gear, nro disturhanccs th.tt arc antinl,atcd to occur <br />durinc rhr upcouting }c;tr. reclamation Ilyd trill I>< pcrli,rmrd during the anninc dear. rhr d:nc. li,r the hegunung <br />o(acutr „prratiuns. and the dare nctite operation. rcaxd I~,r rhr tear. it am. <br />1'Icase attach tour revived Nriuen annual renort vul •urnuul renort Worn to Ihi•c form I he :\nnunl Report <br />.~ Fcc rcyuircnunt is not met until oe hate rcccitcd the I'ullooin{; romponcnts: fee. renort. and ussociatcd <br />n~ 1 \II arc required rrk:u~dless of the level of disturbance ur ahsence of disturbance Burin{; the peer ions <br />ya•arl. I'lr~t,r ,oar Nr,rr ,ur .,.G ~rr„r~•d, rdb,~!ra m.q• tJr:d ~ l,•arl,v Jrliur.ur, mtrl rrtrhtJ,~, rhr ,rhos rl<•mruh nt,n~ <br />~, ullirr i„r , t u rmr,r rr/~.,r1 <br />I)itisuat records indicate rhr liillotsing pennince anuact information. Please verilj •ntd make an} necessan <br />chance.: <br />I'crnuttce Contact: \likc Bucklcn <br />Pemtiuec \'ante: Bucklcn Gquipntcnt Cwnpam <br />Address: SI)-l \. ?i1h -\te <br />l mrlrt. Cu l;o6i l <br />Phone Nuntbcr: (9?II) i59-0?.II <br />I;u lxumher (9?III iii-0?'I <br />If )ou It:nc additional conunents and%or intt+nn;rtion that .huuld he pmvidrd rt, the I)itisiun. please protidc it <br />Ixlott or attach it to thu h,rm along tt i}t your o ritten ruporl :uul map. Annual Kclx+rt instnwtiura are enclosed. <br />/"~ ~' <br />Signautrc of Corporate O1liccr. (hsncr, ur Iksignec <br />i <br />y- ~ U <br />Hate <br />