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~ III IIIIIIIIIIIIIIII <br />ANNUAL REPORT <br />PERMITTEE NAME: Custom Crushing, Inc. <br />PERMIT NO.: M-79-205 <br />OPERATION NAME: MMM/Chambers Pit <br />ANNIVERSARY DATE: August 15,1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Garfield <br />C <br />~'~I/I <br />'~ilii 2 6 1999 <br />Division of Minerals & Gectv(;; <br />According to C.R.S. 34-32-116(3)(a), 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 <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach your revised annual report map and written resort to this <br />annual report. Please note that nn adegnate[y labeled map that clenrly delineates and <br />includes the above elements mny sn~ce for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name: Bill s, Bailey <br />Address: r•o, sox 1556 <br />Rifle, CO 81650 <br />Custom Crushing, inc. <br />Phone No.: ( 970 ) 625-3735 <br />Fax No.: ( q,71~~,~~s~n~ <br />If there are additional comments and/or information that should be provided to the Division, <br />please provide it on a separate sheet and attach it to this report form along with your map and/or <br />written report. <br />L ` <br />Signature of Corporate Officer, or Own . <br />07/22/99 <br />Date <br />INSTRUCTIONS ON BACK <br />