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Permittee Contact: <br />/ 44 <br />Perrnittee Company: <br />d,4? wet, PeAd y -,n ; <br />Address: <br />1171ut;rc P; Ale_ lb2, <br />/4-L4- os,it , C0 f3, IOI <br />Phone Number: <br />119- 513 5103 <br />Fax Number: <br />714- 58 55,- - <br />Email Address: <br />glenao Sok-rkwayu7. cork <br />10/14/2011 07:53 7195895522 <br />SOUTHWAY CONST CO PAGE 02/02 <br />13. Attach a map to this report that accurately depicts the permit boundary, current affected area boundary and <br />location of the acreages specified in items 7 -12 and 14. Please check the appropriate response below: <br />UPDATED MAP ATTACHED CONDITIONS UNCHAGED - PREVIOUS MAP ACCURATE: <br />14. Is weed control being conducted in accordance with an approved Weed Control Plan? NO N/A <br />If "YES ", indicate the weed species, control area, control type, application rate and treatment date on the <br />report map. 45 p✓i C © . 2AL f�- -•4.'tJ <br />15. Is adequate topsoil reserved for reclamation, based on your approved permit? NO N/A <br />If "NO ", please explain: <br />16. Is the reserved topsoil vegetated /stabilized in accordance with Rule 3.1.9(1)? NO N/A <br />If "NO" please explain: <br />17. If mining has exposed groundwater, is the site in compliance with the approved mining,pl • nd Office of the <br />State Engineer (Well Permit, S.W.S.P., and /or Permanent Augmentation Plan)? X6 NO N/A <br />18. Are all hazardous materials stored within approved spill containment structures? NO N/A <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? NO N JA <br />20. Is your basis for legal right to enter is still valid? <br />21. Does your permit require you to submit monitoring information annually? <br />if "Yes ", please attach the required monitoring results to this annual report <br />Please provide current contact information: <br />, */./ <br />Signa • of Corporate r, Owner, or Documented Designee <br />YES <br />NO <br />N/A <br />I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site <br />operations are being conducted in accordance with the Division approved mining and reclamation plans. <br />/0/ /0// <br />Date <br />