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<br />PERMITTEE NAME: Valco -Rocky Ford Div <br />PERMfF NO.: M-1977-222 <br />OPERATION NAME: Rocky Ford South Pit <br />ANNNERSARY DATE: January 25, 2005 t 9 Lc~ <br />h <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Otero <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 operator <br />shall submit the annual fee, a report_and map, showing the extent_of current .disturbances_to-affected land, _ _ <br />reclamation accomplished to date and during the preceding 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~pur revised written anm~al reEnrt and anm~al report map to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Wayne Adams <br />Permittee Name: Valco -Rocky Ford Div <br />Address: P.O. Box 550 <br />Rocky Ford, CO 81067 <br />Phone Number: (719) 254-7461 <br />Fax Number: (719) 254-7462 <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 />nt- l/~~b <br />Signature o Corporate Officer, Owner, or Designee <br />/-3-p6 <br />Date <br />