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<br />112 Attachment r. <br />Permittee Name• Valco ~.p. /?J~ ~~7~ Gui~.~i5v~/~ ~~'-° =~ <br />Operation Name: V''DER /A~C/Q ~~ <br />Permit No: 78-287 RECEIVEp <br />Anniversary Date: October 5 ACT f) 9 700 <br />MINED LAND REC AMATlOly 0lylSlON <br />Please complete the following and return this form with you6olb.~~L.~(+~aturalResources <br />reclamation data. <br />Enclosed are: (Check box(es)) <br />I~ <br />'~` <br />I I <br />Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />Annual Report <br />Map <br />~.~ <br />v~~ ~G <br />~~ ~~~ ~~, <br />Signature <br />(Rev. 5/84) <br />Doc. No. 1805 <br />