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<br />F PN t'W It Cea Nd;u,c; .._.~. i1 Ou uuthbu C'ouCrVC~ U:'/
<br />' PermiC No. '.a ~'7'I-U.t9
<br />f Operation N.une: l+caily ^^rz h;r
<br />/ Anniversary Uace: ~yJ~~a~^o.~~.~;,a:y _, o~ONy
<br />TOCa1: ~1'Ooo.QSJ ;D~., •_ .,. ..... ie r>.ary Gflcbl
<br />1. a. Permitted acre:.7e: ~~~~~ :>. Cou.^.:y ~.:::e:'_ :r,:r:e is lceated:
<br />2. Has Uzis mine bee;, yrantcti ~r E:dt~cr Rr.RY cGSb't;PtON S:'!: :'US?
<br />Does Chis mine operate D'.~, 1~: or iESS than 160 days per year?
<br />3. Dues this mine have a p::a :ed r'ec?a:nz, ~.: o^ ricer"-
<br />'1. 'POtal acres afiac~:'~,: tiur_:.,I _.~ :'epo:t ;~~ac:
<br />5. Toca'_ acres racla:a~~r9 fcr ^he ;:ere .._. .
<br />6, Total number of acr~as in topsoil replacement scaye:
<br />a. Average thickness of copsozl replaced:
<br />7, Total number of a~~ras sol:':'.,•,:: _
<br />_ a. 4isC species :. ~.-, ~ded o :, ~."u::.y taR'.'.: rci,~~: ~- /,vac ~~.'I back
<br />' 8, ~ For non-phased opri.acions prov '. clo cfa ~_~'~; VzC n.,cc:,,n :: <~a r,cd~.
<br />a. Date racl~amac wn beyan.
<br />MESS '~0
<br />,_..
<br />SORE LESS~~~:
<br />YES ;.NP..'.-..,
<br />9, The type and approx. mate quantity of Fertilizers, orgam.c material or soil ~"`~i.q;~•11?tiw}>''
<br />.. " 'K',:. is ",
<br />conditioners used [~r ei~e rt'u::~ ;~c;ar:~ ~ ~_ ~'~;
<br />10. Estimated total acres co be aftecced to the ne~;c report year:" 5 / -~~~ ~ '~~
<br />\ ~ ~. <
<br />11. COhIMENTS: \~y~~'\\v-1 \.. SQ'n'~t 'A.RRw Oy11u ~2Q, 1na`12 ..:.~::'~~~'`~~yfix,
<br />~_ _ ... f'
<br />r A
<br />.,; ~., .,,~r. ~.
<br />• Please show the to Cron of the a~_ce.,yc tvr :ter: - 6 cn your map~^ Indicate ~~'~
<br />the phases of the rec'ara :_~r. .~r':cr ^, ve oee,~. r .:_c~. ,; rein ted ~,:t~, your t1fnBCabla ~ '"
<br />For phased operation, sh_~ .ace:, [,tract .on ceased anti c.,:e rec _-,rnacion beyan. .:,.t~~".r~~; ~r,'v13
<br />'" NOTE: IE there have not beer: any c:~.anyes sz.^.,e .,._ .:,,sc %r^r; •.a1 report and you
<br />pYa Viou3ly suDlni CC2C1 G .map I.Oi C'i. :..c rec'C iy' depl CtS Cha Curt'anc u!~renye in iCernS 2 Chl04Qh'1~ ~""
<br />6, then a new maP is unneot.~sary. .,:;;ever, this muse ba seated above. ___ ~~~:
<br />Please type or prin~t+-curran~~cor.cacc me, 1l:r,g a~idr.-,s, and phonz nwnber below: ~ ~~."',',~`y%i
<br />Contact Name: (~~ I ~-
<br />Ff10n8'. ~~~ 5 J~(;
<br />S{
<br />r ^ O C 1.
<br />\ n~~ i(;1. ~t~J.
<br />Company: ~~ (~\C.'.', ~.r~ ~ I .'a
<br />Address: ~~~ U X X, .~~~ ~ '.::j ~`~~'~ ~~~
<br />1 ~
<br />Federal Tax ID No. or Socra' Securacy t,o.: '.
<br />", F9if~h ~;y i~
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