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. ///%//j/%/% • r <br />999/////x// <br />ANNUAL REPORT <br />PERMITTEE NAME: Georgia-Pacific Gypsum Corporation <br />PERMIT NO.: M-1977-247 <br />OPERATION NAME: Coaldale Quarry <br />ANNIVERSARY DATE: Apri128, 2000 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Fremont <br />i~~~r~~~J~® <br />ANR 2 g 2000 <br />nivisinn of Minerals & Geotog~ <br />P~ 101 <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an operator shall <br />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 <br />to occur during the upcoming year, reclamation that will be performed during the coming year, the <br />dates for the beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised annual report map and written report to this annual report. Please <br />note that nn adequately labeled map drat clearly delineates and irtck~des the above elements may <br />since for n written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: '~rr-"~ESV1 S . k~-~-o Company: t~'~~t~ ~w~ <br />Address: Qo~iox '338 Phone No.: (~°)) 99-Z--419, <br />t~oiTAX). Cfl 81223 FAX No.: (~~~) °J~42--4t~~ <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />Signature of Corporate Offi er, or caner Date <br />/NSTRUCTIONS ON BACK <br />M.~PERM111TU7 ASTERDOCUM ENrSVv1-AF-01 <br />