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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />I <br />~ ~~ <br />ANNUAL FEE and REPORT REQUEST <br />Occidental Oil Shale, Inc. <br />/1CI-1977-424 <br />Logan Wash <br />March 28, 2007 <br />RECEIVED <br />~ MAR 1 2 2007 <br />GRAND JUNCD~S(~ ~ ~F~ <br />~CLAtdAi'10M tA0~6NG S SAFETY <br />$$550.00 (Due on or before your anniversary date) <br />Garfield <br />According to-C.R.S.-34-32.5-1-16.or_C.RS.-34-32-1-16, each year, on-the-anniversary-date-ofthe-permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual report map to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, reAOrt, and <br />associated map. If no new disturbances or reclamation have occurred durinc the previous vear and no <br />new chances to the previous year's map are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Pertnittee Contact: Franklin Miller <br />Petmittee Name: Occidental Oil Shale, Inc. <br />Address: C/o Glenn Springs Holdings, Inc. <br />2480 Fortune Dr., Ste. 300 <br />Lexington, KY 40509 <br />Phone Number: (859) 543-2100 <br />Fax Number: (859) 543-2171 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br />/~i~c// 8 Z~7 <br />Date <br />M:IPERM7'IV~fAS7ERD000MENTSMI-AF-02.DOC <br />