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~~~~ / <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 />Ace West Trucking, Inc. <br />M-1987-103 <br />East Douglas Pit <br />August 24, 2002 <br />RECEIVE® ~^ - <br />NOV 2 6 2002= <br />Division 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-I 16 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />- - shall-submit-Ehe -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 [he 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 vour revised written annual report and annual report mau 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 Tracking, Inc. <br />Address: P.O. Box 250 <br />Rangely, CO 81648 <br />Phone Number: (970) 675-2753 <br />Fax Number: (970) 675-2702 <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 />I~o~l c,.4~ c~ . ~ t~t.Q--- <br />Signature of Corporate Officer or Owner <br />~~-~~-c~ <br />Date <br />M:~PERMRNIASTERDOCUMENTSVvI-AF-01 <br />