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~t <br />t <br />ANNUAL F'~E and~PORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Ace West Trucking, Inc. <br />M-1999-007 <br />North River Gravel Pit Extension <br />April 28, 2007 <br />~,- <br />~~A~ !~,1 s~~~-A <br />~, „ <br />it i+Z;ns anc' S2f y°n. <br />$$281.00 (Due on or before your anniversary date) <br />Rio Blanco <br />According to C.R.S. 34-32.5-I 16 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />- - -shall-submit_the.annual f_ ee,_a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the "prece iiig year,-new-disturbances-that-are anticipated to occur _ <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach Your revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred durinc the previous year and no new chances to <br />the previous Year's map are necessary, then no new maa is required, arovided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may suffice for a written report. <br />Division records indicate the fallowing permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: ~nald O. Rooks, Jr. <br />`___) ~"~ ~.,4.~ (~ . Ili . ,~. <br />Permittee Name: Ace West Trucking, Inc. This pit i s inactive . _ <br />Address: P.O.Box250 No mining is being done <br />at this time <br />Rangely, CO 81648 <br />Phone Number: (970) 675-2753 <br />Fax Number: (970) 675-2702 <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 enclosed. <br />~~'1~4~~ ~~~~ ~` <br />Signature of Corporate Officer, Owner, or Designee <br />~-z~=~'~ <br />Date <br />