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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Ace West Trucking, Inc. <br />M-1999-007 <br />North 12iver Gravel Pit Extension <br />Apri128, 2003 <br />RECEfVED <br />MAR 2 4 2UU3 <br />Givision of Minerals and Geology <br />$281.00 (Due on or before your anniversary date) <br />Rio Blanco <br />_ _ According to C.R.S. 34-32.5-116 or C.R.S. 34_32_ 116,_each_year, on_the annixersary_date ofthe.permit,.an operator -_. <br />shall submit the annual fee, a report and map showing the extent_of current disturbances to-affected land, -- <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach y~yir revised written annual rennrt and anneal tenor[ m ~n to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact; Donald O, Rooks, Jr. <br />Permittee Name: Ace West Trucking, Inc. <br />Address: P.O. Box 250 <br />Rangely, CO 81648 <br />Phone Number: (970) 675-2753 <br />Fax Number <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 enclosed. <br />~1„ a ~~ _ <br />Signature of Corporate Officer, Owner, or Designee <br />~ ~ ~~-v3 <br />Date <br />M:~PERMITV.7ASTERDOCUMENTSU7-AF-01 <br />