2006-09-11_REPORT - M2001035 - Laserfiche WebLink

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m~v/z- 9at``~ ~g~ ,/ANNUAL FEE and REPORT REQUEST RECEI!/ED PERMITTEE NAME: //ACA Products, Inc. $EP ~ ~ 2006 PERMIT NO.: i/ M-2001-035 ~ i~ision of Reclamation, OPERATION NAME: Trout Creek Pit Mimn9 and Safety ANNNERSARY DATE: September 19, 2006 ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) COUNTY: Chaffee According to C.R.5. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator shall submit the annual fee, a report and map showing the extent of cun•ent disturbances to affected land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning of active operations, and the date active operations ceased for the year, if any. Please attach vour revised written annual report and annual report map to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated moo (All are required regardless of the level of disturbance or absence of disturbance during the previous year). Please note that an adequately labeled map that clearly delineates and includes the above elements may since for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Jon Hollenbeck Permittee Name: ACA Products, Inc. Address: P.O. Box 1887 Buena Vista, CO 81211 Phone Number: (917) 395-3790 Fax Number: (719) 395-3794 If you have additional comments and/or information that should be provided to the Division, please provide it below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. ~7~' Y Signature of o rate Officer, Owner, or Designee gl-~-lob Date Tl