2011-06-10_REPORT - M1979206

• Permit No: M1979206
• IBM Index Class Name: Report
• Doc Date: 6/10/2011
• Doc Name: Annual Fee/Report/Map
• From: U S Soil Cond. Co.
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

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PERMITTEE, NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
AN AL FEE and C PORT REQUEST
CU S Soil Conditioning Company
C/M-1979-206
Maverick Placer
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June 16, 2011
$$791.00 (Due on or before your anniversary date)
Fremont
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
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, reclamation that will be performed during the coming year`the dates T6fItthe 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 may 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 vear and no new changes to
the previous year's map are necessary, then no new map is reauired, provided that the Operator shall state
this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the
above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Joseph E. Lionelle
Permittee Name: U S Soil Conditioning Company
Address: P.O. Box 926
Salida, CO 81201
Phone Number: [phone]
Fax Number: [phone]
have additional comments and/or information that should be provided to the Division, please provide it
or attach if Rthis form alJpng with your written report and map. Annual Report instructions are enclosed.
of Corporate Officer, Owner, or Designee
6-'-//
Date