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~ - ~ ~ G~ <br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANN1TAi, FF.F. and REPORT RF.OiTFST ~9 19 2004 <br />~, Division of Minerals & Ceef00y <br />Natural Soda, Inc. <br />M-1999-OSl <br />Rock School Lease Experimental Nahcolite Mine <br />February 28,2004 <br />$550.00 (Due on or before your anniversary date) <br />Rio Blanco <br />i <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an <br />operator shall submit the annual-fee,-a-repast-and map-showing the-extent_af_current disturbances to affected _ <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active' operations ceased for the yeaz, if any. <br />Please attach y;nur revised written anm~al rennrt and annual repnrf main to this form- Please note that an <br />adequately labeled map that clearly delineates ;and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Ed Baker <br />Permittee Name: Natural Soda, Inc. <br />Address: 3200 CR 31 <br />Rifle, CO 81650 <br />Phone Number: (970) 878-3674 <br />Fax Number: (970) 878-5866 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />~.~~~ <br />Signature of Corporate Officer, Owner, or Designee <br />Date <br />M:~PERMIrVNASTERDOCUMENTS/M-AF-02.DOC <br />