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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />+'1P -4 P-?-7- <br />ANNUAL FEE and REPORT RE VEST <br />EnCana Oil & Gas (USA), Inc. <br />M-2005-069 <br />West Fork Pit <br />October 13, 2008 <br />$791.00 (Due on or before your anniversary date) <br />Garfield <br />OCT 2 `-.2DO8 <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-disturbance`s that are dnticipated to occuC <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 your revised written annual report and annual report may 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 during the previous year and no new changes to <br />the previous vear's map are necessarv. 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 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: ?teorrelse?r <br />JA506 t c.AK&4 <br />Permittee Name: EnCana Oil & Gas (USA), Inc. <br />Address: 2717 County Road 215, Suite 100 <br />Parachute, CO 81635 <br />Phone Number: <br />Fax Number: <br />(970) 285-2691 <br />Cg70) Z85- Z(o Eo <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 />Si a re of Corporate Officer, Owner, or Designee <br />10/(o/o2 <br />Date