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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 COLORADO <br />D I V I S I O N a F <br />Phone: (303) 866-3567 RECLAMATION <br />FAX: (303) 832-8106 <br />HARD ROCK/METAL MINING MINING <br /> <br />REGULAR OPERATION (112) SAFETY <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: R] There is a File Number Already Assigned to this Operation <br />New Application (Rule 1.4.5) Amendment Application. (Rule 1.10) <br />Conversion Application (Rule 1.11) <br />Permit # M- 1983 194 - (provide for amendments and conversions of existing permits) <br />The application for a Regular Operation Reclamation Permit contains three major parts: (1) the application form; (2) Exhibits A-S, <br />Geotechnical Stability Exhibit and Addendum 1; and, (3) the application fee. When you submit your application, be sure to include <br />one (1) completed, signed and notarized gray original and one (1) copy of the completed application form, two (2) copies of Exhibits <br />A-S, the Geotechnical Stability Exhibit, and Addendum 1, and a check for the application fee described under Section 4 below. <br />Exhibits should NOT be bound or in a 3-ring binder; maps should be folded to 8 1/2" X l l" or 8 1/2" X 14" size. To expedite <br />processing, please provide the information in the format and order described in this form. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, all information described below. <br />1. Applicant/operator name: Natural Soda, Inc. <br />1.1 Type of organization (corporation, partnership, etc.); Corporation <br />2. Operation name (pit, mine or site name): Natural Soda Nahcolite Mine <br />3. Permitted acreage (new or existing site): 73 permitted acres <br />3.1 Change in acreage (+ or -) 8150 acres <br />3.2 Total acreage in Permit area 8223 acres <br />4. Fees: <br />4.1 New Application $2,156.00 application fee <br />4.2 New Quarry Application $2,674.00 quarry application <br />4.3 Milling Application (Non-DMO) $3,565.00 milling application <br />4.4 Amendment Fee $1,783.00 amendment fee <br />4.5 Conversion to 112 operation (set by statute) $1,725.00 conversion fee <br />5. Primary commoditie(s) to be mined: nahcolite, a naturally occurring sodium bicarbonate (baking soda) <br />6. Name of owner of surface of affected land: US Department of Interior, Bureau of Land Management (BLM) <br />7. Name of owner of subsurface rights of affected land: BLM <br />If 2 or more owners, refer to Exhibit O. <br />8. Type of mining operation: Surface Underground X In-situ <br />Office of Office of <br />Mined Land Reclamation Denver - Grand Junction r Durango Active and Inactive Mines <br />