2010-02-01_REPORT - M1983194 ‎(4)‎

• Permit No: M1983194
• IBM Index Class Name: REPORT
• Doc Date: 2/1/2010
• Doc Name: Annual Fee/Report/Map
• From: Natural Soda, Inc.
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

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A?jNNUAL FEE and REPORT REQUEST
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PERMITTEE NAME: Natural Soda, Inc.
PERMIT NO.: / M-1983-194
OPERATION NAME: Nahcolite Project
ANNIVERSARY DATE: January 31, 2010
ANNUAL FEE DUE: $633.00 (Due oil or before your anniversary date)
COUNTY: Rio Blanco
C21VED
FEB 0 1 2010
Division of Reclamation,
Mining and Safety
According-to C.R.S._34-32.5-1 16 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an -
operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected
land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to
occur during the upcoming year, reclanation that will be performed during the coining year, the dates for the
beginning of active operations, and the date active operations ceased for the'year, if any.
Please attach your revised written annual report and annual report mall to this form. The Annual
Report & Fee requirement is not met until we have received the following components: fee, report, and
associated map. If no new disturbances or reclamation have occurred during the previous year and no
new changes to the previous year's nral> are necessary, then no new map is required, provided that the
Operator shall state this in the Annual Report. Please mote that an adequately labeled nrap that clearly
delineates and includes the above elements may sr ffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: 44H-H-G-man

Permittee Name: Natural Soda, Inc.
Address: 3200 RBC 31
Rifle, CO 81650
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are
enclosed.
Signature of Corporate Officer, Owner, or Designee
oz o S /o
Date
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