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:: <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Natural Soda, Inc. <br />M-1999-051 <br />Rock School Lease Experimental Nahcolite Mine <br />February 28,2002 <br />$550.00 (Due on or before your anniversary date) <br />Rio Blanco <br />~o~^OL <br />23 n~„~, <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected - _ <br />- tand,~~eclamation accomplished-to~ate andauring the preceding year, new disturbances [hat are anticipated [o <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for [he <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual reuort and annual report map to this form. Please note that an <br />adequately labeled map that clearly delineates and incltules the above elements may suffice for a written <br />report. <br />Division records indicate the following perntittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Roger Day <br />Permittee Name: Natural Soda, Inc. <br />Address: P.O. Box 1330 <br />Rifle, CO 81650 <br />Phone Number: <br />Fax Number: <br />(970)625-9134 <br />(970)625-9137 <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 or Owner <br />~' ~,~LVaZ <br />Dale <br />~i <br /> <br />~ ~- <br />RECEIVED <br />FE6 1 3 2002 <br />Division oI Minerals and Geology <br />ANNUAL FEE and REPORT REQUEST <br />M 1PERMITN4ASTERDOCIJMENTS/M-AP-02. DOC <br />