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V-- <br />PERMITTEE NAME: <br />PERMIT NO.: <br />ANNUAL FEE and REPORT RE VEST <br />First Bentonite Company Colorado <br />VI-1977-231 <br />6Mk e1>t <br />RECEIV J) <br />111JUL 212010 <br />OPERATION NAME: LBC Bentonite Pit Division of Reclamation, <br />ANNIVERSARY DATE: August 23, 2010 Mining & Safety <br />ANNUAL FEE DUE: $$323.00 (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 />W year new disturbances that are anticipated to occur <br />reclamation-accomplished to-date and during the rp e_ced? <br />during the upcoming year, reclamation that will be performed during thecminyyear, t?fe`aates of ffiie teginning <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 vear's man 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: Pamela Wedige <br />Permittee Name: First Bentonite Company Colorado <br />Address: 215 Teller St. <br />Salida, CO 81201 <br />Phone Number: (719) 539-4693 <br />Fax Number: <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, per, or Designee <br />Date