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.~ <br />~f ~'~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Nalco Gunnison Concrete Division <br />~M-1977-023 <br />Ready Mix Pit <br />January 23,2007 <br />$$688.00 (Due on or before your anniversary date) <br />Gunnison <br />JAM 2 41007 <br />iswn of Reclamation, <br />Mining and Safety <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_yeaz, new_disturbances_that_are-anticipated_to-occur- - <br />during the upcoming yeaz, 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 vour 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 vear and no new chances to <br />the previous year's map are necessary. then no new map is required, provided 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 since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Ed Stewart <br />Permittee Name: Valco Gunnison Concrete Division <br />Address: P.O. Box 837 <br />Gunnison, CO 81230 <br />Phone Number: (970) 641-0951 <br />Fax Number: (970)641-0954 <br />If you have additional comments and/or information that should be provided to the Division, please provide <br />below or attach it to this form along with your written report and map. Annual Report instructions aze enclosed. <br />Signature of Corporate Officer, ner, or Designee <br />~ ~~~ ~ ~~ <br />Date <br />