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otice of Intent to Continue Mining Operations <br />Annual Report <br />PERMITTEE NAME: Goose Haven Sand & Gravel, Inc. <br />PERMIT NO.: M-1984-099 <br />OPERATION NAME: Bailey Pit <br />ANNIVERSARY DATE: September 29, 2004 <br />TOTAL: $688 <br />~Lx^ <br />1. a. Permitted acreage: fie"' b. County where mine is located: Weld County <br />2. Has this mine been granted TEMPORARY CESSATION STATUS? <br />Does this mine operate MORE or LESS than 180 days per year? <br />3. Does this mine have a phased reclamation plan? <br />4. Total acres affected during the report year: (*) <br />5. Total acres reclaimed for the report year: (*) <br />6. Total acres in various stages of reclamation: (*) <br />a. Backfilled: ~ <br />b. Graded: <br />c. Seeded: ~ <br />(list species seeded /seeding rate for report year on back) <br />d. Topsoil replaced: o <br />(average topsoil thickness replaced: ~ <br />Yes ITT <br />More s <br />`mss No <br />v <br /> <br />7. The type and approximate quantity of fertilizers, organic material or soil conditioners <br />used for the report year: (*) ~ <br />8. Estimated total acres to be affected in the next report year: (*) ~ <br />9. COMMENTS: <br />(•) Please show the location of the acreage for items 4 through 6 on your-map (••). Indicate the phases of the <br />reclamation that have been completed, correlated with your timetable. <br />(**) If there have not been any changes since the last annual report and you previously submitted a map that <br />correctly depicts the current acreage in items 2 through 6, then a new map is not necessary. However, you <br />must state this fact above. <br />Signature: ~4~- ~~1~-r-SQL-- Date: ~'~ ~ ~4 ~ '~ <br />Please type or print current contact name, mailing address and telephone number below: <br />Contact Name: Doug_Tiefel Phone: 303-665-9390 <br />Company: Goose Haven Sand & Gravel <br />Address: P.O. Box 17130 Boulder CO 80308-0130 <br />Federal Tax ID No. or Social Security No.: <br />