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PERMITTEE NAME: <br />PERMIT NO.: <br />ANNUAL FFI and PORT REQUEST <br />GCC Rio Grande, Inc. <br />/M-1997-064 <br />0 K. <br />ku l- <br />MOGEVIM <br />/UL U 6 2010 <br />OPERATION NAME: Salt Canyon Project Dtvipian of kcc1Qnv ion, <br />tlinIng and Safety <br />ANNIVERSARY DATE: July 9, 2010 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Fremont <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 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 man 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: -R-e I trick l?tl??CL1V0.?t.? C ACLAT VAC&AcaSat <br />Permittee Name: GCC Rio Grande, Inc. <br />Address: 3372 Lime Road <br />Pueblo, CO 81004 <br />Phone Number: (719) 647-6800 <br />Fax Number: (719) 566-7796 <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. tA' <br />/-,,, 14 X/ ign ure of C rporate Officer, Owner, or Designee <br />o <br />712-1,2olo <br />Date