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Q? <br />ANNUAL FEltand REPORT REQUEST <br />PERMITTEE NAME: ` Valco - Rocky Ford Div REC F l\lFD <br />PERMIT NO.: ' /M-1977-222 AAN 122009 <br />OPERATION NAME: Rocky Ford South Pit Division of Reclamation, <br />ANNIVERSARY DATE: January 25, 2009 Mining and Safety <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Otero <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 disturbances that are anticipated to occur <br />during the upcomirigyear, reclamat-ion-that-wil.l._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 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 during the previous year and no new changes 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 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: Herb K. Pearson <br />Permittee Name: Valco - Rocky Ford Div <br />Address: P.O. Box 550 <br />Rocky Ford, CO 81067 <br />Phone Number: (719) 254-7461 <br />Fax Number: (719) 254-7462 <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 />Signature of Corporate Officer, Owner, or Designee <br />C Z-,T-??1 <br />Date