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iii iiiiiuiuiii iii • ~ `\J5/(' <br />999 ~( \ <br />ANNUAL REPORT ~ , /` ~j <br />~,// /~ <br />PERMITTEE NAME: Georgia-Pacific Gypsum Corporation t0~ <br />PERMIT NO.: M-77-247 cCE~VEG <br />OPERATION NAME: Coaldale Quarry APR 2 8 1999 <br />ANNNERSARY DATE: April 28, 1999 ,., ,,rytinerafS&Geob9Y <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Fremont <br />In order to ensure that our records are up to date, please attach your revised annual report map and written <br />report to this annual report. Note that a written report is not necessary if the map addresses all the <br />items listed in the attached instructions concerning mining disturbance and reclamation update. <br />Please type or print the current contact person's name, mailing address, and phone number in [he space <br />provided: <br />Contact Name: 4.~NNE~NS . KILO Company: ~~uQ-iT~~NC. <br />~O <br />Address <br />: ~rry~ '3zi~ Phone No.: (" }~°~ ) 94Z'~Fl}R, <br />/ <br />'~ <br />l oTo'P ~~ $~ZZ'zi <br />{'cX1 Fax No.: (~-~ ~ ) X4'2.-41 {~ <br /> ~ <br />Comments:: ~w SV 2~ onEYtATio/NS ant ScH EOV.t~ 4~~ A'PP2oyF tj <br />~~Z.M\T HM1><NOV'~~N"~ ( \'~~~{~ ~S~P'SUM M~NIt,L~ '~\UF\\ny+Ll~j <br />nQ~u~n ~ rj}tJT To _QS~V._l^! _.~__~J..~.-QES 901000 TGIVS <br />~N'P<iUM 1'~ \~J`~°~, ~nNL-~r1Lw/>.t,_ N~t1W+>.LU~ ~isn~-s--oo~~D <br />'t'o \S~ L Stnoe.c-. 1~n noo ~ot.~s /~~~J~). ~v~/F-rartior.~ u1oTz~. <br />1NGL. S~~D~~/ 1 t~~.t-.~-\-1~h1LI t ~~~ ~,2~n~ S~OU~ \N/o'tA1-lJ.kTlOl~f , <br />5~~ G-P~~PS~T~ ~~T~ <br />Signature of Corporate Officer, or Owner Date <br />M'1DNRM11 L1h1ASTERDUI ~AF-01 <br />