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r <br />~ • iii iiiiiiiiniii iii <br />.. ~ RECEIVED <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br />Total: <br />Notice of Intent to Continue Mining Operations QCT <br />112 Annual Report 3 ~ 19g~ <br />Robinson Brick Company <br />M-81-148 <br />Chieftain South Mine <br />11/01/96 <br />OIVly~pn W rvUnbrQ~p 4 ~bblbyy <br />$550.00 (Oue on your Anniversary Date) <br />1. a. Permitted acreage: /3/.S/ b. County where mine is located: Je ~Sers oti <br />2. Has this mine been granted TEMPORARY CESSATION STATUS? YES J~0 <br /> Does this mine operate MORE or LESS than 180 days per year? MOR LESS <br />3. Dees this mine have ~ phased reclamation plan? l'cS NO <br />4. Total acres affected during the report year:* S~, 9/ <br />5. Total acres reclaimed for the report year:* 8- S <br />6. Total acres in various stages of reclamation:* <br /> a. Backfilled: 20.9_ d. Topsoil replaced: 20. 9 <br /> b. Graded: ~ 0, 9 Average topsoil thickness <br /> c. Seeded: ~ D, 5 replaced: ~~ " <br /> List species seeded & seeding <br /> rate for report year on back <br />7. The type and approximate quantity of fertilizers, organic material or soli <br /> conditioners used for the report year:* - <br />8. Estimated total acres to be affected in the next report year:* <br />9. COMMENTS: <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 />** NOTE: 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 to items 2 <br />through 6, then a new ap is unnecessary. However, you must state this fact above. <br />Signature: Date: /o~z~ 9~ <br />-T <br />Please type or print current contac/t name, mailing address, and phone number below: <br />Contact Name: /~.ke ~r?i o>',~~, f?E• Phone: (3v3 > 7B3-3OH~7 <br />Company: Royiihson ,Qr~~k L'~.npaN y <br />Address: PO. Box S-ZY3 <br />~er~ver, [O ~D:~17 <br />Federal Tax ID No. or Social Security No.: <br />