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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, Iuc. <br />M-1983-194 <br />Nahcolite Project <br />January 31, 2005 <br />Gtii`~~:.9`;~~N~ <br />JAN 2 ~ 2005 <br />qN~~ <br />~/ <br />Division of fJ:inzr~ls 8i Doology <br />$550.00 (Due on or before your anniversary date) <br />Rio Blanco <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 />-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 yppr revised written annual report and anmial rppn m to this form- Please note fhat an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />report. <br />SEE SECTION 5 AND FIGURE 5-1 OF NATURAL SODA'S ANNUAL REPORT <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: PERMITTEE INFORMATION CORRECT <br />Petmittee Contact: Ed Baker <br />Permittee Name: Natural Soda, Inc. <br />Address: 3200 CR 31 <br />Phone Number: <br />Fax Number: <br />Rifle, CO 81650 <br />(970)878-3674 <br />970 8785866 <br />If you have additional comments andlor 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 />~~ <br />Signature of Corporate Officer, Owner, or Designee <br />~~t,~,wi ~~ , 07cz~J~ <br />Date <br />M:~PERMI7\MASTERDOCUMQJ'CSIM-AF-02.DOC <br />