REP23473

• Permit No: C1996084
• IBM Index Class Name: Report
• Doc Date: 3/4/2005
• Doc Name: 2004 Annual Reclamation Report
• From: Peak Project Management, LLC
• To: DMG
• Permit Index Doc Type: Annual Reclamation Report
• Media Type: D
• Archive: No

I Identlflcatfon
~`I Inspector's Initials -~~~
~IJI' ~'~, Grower's Initials ~~
V 1,~I ~1~. Field Number ~~
l COLORADO DEPARTMENT OF AGRICULTURE Date .P~4~3
DIVISION OF PLANT INDUSTRY
700 Kipling Street, Suite 4000
Lakewood, Colorado 80215-8000
[phone]
CERTIFICATE OF INSPECTION
FOR WEED-FREE FORAGE CROP CERTIFICATION
Certified Accarding to the Regional Weed Free Forage Standards
PLEA:IE PRINT IN INK
Growe r
City_ •~
Count i of
This is to certify tha't'fh~
legal c~ascription below,
Act 35.27.5
(check one)
gl c~teria cont
gn~t~ of Insp t
identify Forage Crop
Address/Box Numcber SS/J ,~ /lg~ 9~
Zip Code d'//2S Phone 7/9-, eS7~,P
forage crop, owned by the aforementioned grower and grown on the land identified in the
has been officially inspected pursuant to the Colorado Weed Free Forage Crop Certification
)~ HAS
^ HAS NOT
inec~rt those guidelines.
S ~ p3
Inspector Name lease Print) In pe lion Date
Acres nspected ~~~ Acres Certified ~ Cutting Date ~ -la - ~
Amour 1. Harvested from Certified Acres 5~ q~i~ Bales
Bale Si:[e (check one) ~: ^ large round ^ large square
~S ~ ~~ ,~ small square ^ other
NOTICE: This inspection is valid if the forage crap des
of this document. This certificate shall be Issued only
of forage
Inspecwr
DPI•WF•OS DblrlDutlon:
pypp YYhft~ - Grower Pink -DPI Gn~n - Innpeclcr
crlbed herein Is cui wtthln ten {10) days from the date
upon final verification of date of cutting and amount