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<br /> ;Permitcae Nam<: \'alcu Cuanlson Concrete D:.v '~ ,~t
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<br />' Permit No. M-'/"/-D"[: ,
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<br />///
<br />/ Ope rat lun N:mw: Fead; gat.. V•r ~ ..
<br />./
<br />~ An;:i ve rs~ry DdCe: ![lnlla:y :~:. .h>b
<br />'
<br />` ~~::,.
<br />~ Total: ;0.~.
<br />! {D•.i ~: v:. yo~.~r ....:.. vt_i:.ur% Dacel iia'
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<br />,+
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<br />\ 2
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<br />t ''' SY ;fi
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<br />1.
<br />a. P?rnucced acrr~.
<br />,ye: ~-~±
<br />~ b. County ~.;hEr? rnlne iS C,
<br />located: ~ , '
<br /> +: i
<br /> 2. Has this mine been i!ranCEd TEhI!~ORF,RY CESSATION S"'/.';'US'' YE3 ~''~,~
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<br /> Does this mine oper ate MCftL of L6:-:' t~~.an '_97 d;;:; .. ;cur' 4ORE L6S
<br /> J . D~;aa th:s n~: ne ha•.~r a phas.•~•i t ce! ~ r.:r: ; ... _. n?
<br />' '~ YES NQ}
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<br />
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<br /> 4. :vt,l acres affec~. ~ : •.i dur:•_ v:~ repo: ~: ya~ar:' '>„~~0:,,~~-
<br /> 5. Tech] acres roclav.
<br />.~ •,,, ..,
<br />^ad fo. the ^cr_ .._ . ~ . ~ ~ r_F]`•.'.
<br /> t r
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<br /> 6. Total number of• ac res in topsoil r?placemenc scayc: ~
<br />4-,
<br />-.
<br />~ •' `
<br /> a. Average [hicknv~s of copse!' __;~'.-, _erl: l
<br />.,
<br />`M~ ',
<br /> 7. 'COCal nun'~er of a..: ::, serc:..ci~ ~ ,.
<br /> a. List species .. .~. ,,Jed 6 _.-~~,,,.;,y rocv i•;t re[,orc. y.~.•ar on ba .. ` ,~~;, y117~
<br />`•8.
<br />9
<br />10
<br />11
<br />For non-phased OpetationS pran tle daces or.c raccit.n c~•ased: .~
<br />a. Dace recl~amatioi: began:
<br />9'he type and approx•.:nace quantity o: iercaL air:. orb-_n!.c material or soil
<br />condtuoners used _:c Gze :~~p~rt year:' ~ _
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<br />Estimated total acr~_s co be acfecced in the next report year:' ~ ~,
<br />P!?ns? show the loc.t •.ton of the JCreaye for :eeirs S - C cn your rt:ap'•. Indieate''~'`~, .~+
<br />to
<br />the phasas of the reclama•:.;:n wh!c'r~. as•~ie beet com.pleteci, correlated with your cimetdbl~
<br />For phased operations sho~.. laces c:.:crac'tlon ceased and daces rVCiamaci0n began.' ti>~.~c?;,~. ~^
<br />NOTE: if there have no: been any ceu:•.yes since tee lose -u: r. ~: c.. ~ reporC and y0LL ~ ~ ~•~`~~~~~"•:
<br />i ;}7;'
<br />~,reviuusiy' sui;initced a maki .iiiich cGC r:•cc L; Q<picts ti;e current ucreaye in items 2 ChrOUjLb_•/
<br />6, then a new map is unne!~rssazy. Hm.,ev<t. _'n:. ir.ust bo „•.ut~id above.
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<br />S:gr,act.rc: _.~~\\~~ Dace ~' O'~ ~.
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<br />Please typa or prlnc currz:~.: cor.cact ;:~rn< .<a:._^.y cddr._ss, a;:d phone number-belOwi t''!:t; ~•~ .~
<br />Contact Name: ~ Q ~~ ti A,N ~ - © Cj "~'
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<br />Addrass: \` .~ . \~ C~ ~ ~l ~ 1 !#~~', <~?
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<br />Federa'_ Tax ID No. or Social Security ^:c. ~ _ ~a __ l~ S _~_i~~.r7 ' '.1~.,
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