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ANNUAL REYUttT <br />PERMITTEE NAME: Occideptal Oil Shale, Inc. <br />PERNIPT NO.: M-1977-42q <br />OPERA'i`lON NAMH: Logan Wash <br />ANNIVERSARY DATE: March 28, 2000 <br />ANNUAL FEE DUE ON ANNIVERSARY PATS: $550.00 <br />COUNTY: Garf eld <br /> <br /> <br />~:;< ~ , ~: <br />~~. <br />AFC~~ <br />Jib ~2 <br />ono/M~~~a~s~ ~e%9 <br />Y <br />According to C.R.S. 34-32-116(3)(x), each yeaz, on the anniversary date of the permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances that are anticipated to occur duripg the.itpcoming year, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please note that an adequately labeled map that clearly delineates and includes the above <br />elements may su,~4ce for a written report. <br />Please type or print the current contact persoYt',s name, mailing address, and phone number in the <br />space provided: <br />Contact Name: Company: <br />Address: Phone No.: ( 1 <br />FAR No.: ( 1 <br />!f there aze additional comtncnta and/or information that should be provided to the Division, <br />please provide it on a separate sheet and attach it to this report form along with yotu map and/or <br />written report. <br />Sigttature of Corporate Officer, or Owner <br />Date <br />INSTRUC~'IONS ON SACS <br />IQ:WSMdRN1ASt$RDOC~JMBPfI'SIM-AR02DOC <br />