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J 1~ <br />;~ECEI''~D <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Occidental Oil Shale, Inc. <br />M-1977-424 <br />Logan Wash <br />March 28, 2002 <br />$550.00 (Due on or before your anniversary date) <br />Ga~eld <br />MAR 2 1 "~iD2 <br />!;vision of Minerals and GeoloAY <br />According [o 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 report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated w <br />occur during [he 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 year, if any. <br />Please attach your revised written annual report and annual resort man 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: Franklin Miller <br />Permittee Name: Occidental Oil Shale, Inc: <br />Address: C/o Glenn Springs Holdings, Inc. <br />2480 Fortune Dr., Ste, 300 <br />Lexington, KY 40509 <br />Phone Number: (859) 543-2100 <br />Fax Number: (859) 543-2171 <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 />Signature of Corporate Officer or Owner <br />3/~~/~z <br />~~ <br />Date <br />M:~PERM nN1ASTERDOCUMENTS/M-AF-02. DOC <br />