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<br />* Please show the location of the acreage for items 4 - 6 on your map**. <br />Indicate the phases of the reclamation which have been completed, correlated with <br />your timetable. <br />** I~ E: If there have not been any changes since the last annual report and you <br />previously submitted a map which correctly depicts the current acreage in items 2 <br />through 6, then w map is unnecessary. However, this must be stated above. <br />Signature: Date: %(~/9'~" <br />Please type or p~ri/n1/t cu rent contact name, mailing address, and phone number below <br />Contact Name: ~-P(OSE/d"1QfU~~~~/ / Phone: <~3 >a78-990/ •~ <br />Company: <br />Address: .5'O~$/~el f~ <br />ti`9~ <br />~~ <br />Federal Tax ID No. or Social Security No.: ~P <br />~~ <br />sss <br />Notice of Intent to Contin ~e <br />110(2) Annual Re <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br />Total: <br />Jelen & Son Inc <br />M-83-O11 <br />Willow Creek Mine <br />02/23/94 <br /> <br />Mining Operations~EC~1V~t1 <br />10 1999 <br />P;~•~oh~ <br />$225.00 (Due on your Anniversary Date) <br />1. Has this mine been granted TEMPORARY CESSATION STATUS? YES NO <br />Does this mine operate MORE or LESS than 180 days per year? MORE LESS <br />2a. Financial Warranty: $ 2b. Permitted acreage: <br />3. Does this mine have a phased reclamation plan? YES NO <br />4. Total acres affected during the report year:* <br />5. Total acres reclaimed for the report year:* <br />6. Total acres in various stages of reclamation:* <br />a. Backfilled: d. Topsoil replaced: <br />b. Graded: Average topsoil thickness <br />7 <br />c. Seeded: replaced: <br />List species seeded & seeding <br />rate for report year on back <br />The type and approximate quantity of fertilizers, organic material or soil <br />conditioners used for the report year:* <br />8. Estimated total acres to be affected in the next reoort vear:* <br />9. COMMENTS: <br />