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Permittee Contact: <br />R---- / <br />TC 1 (Acid.CoA/ <br />Cc7G�L�iSSi - J/ixr. Z <br />7/9' 523 - ..-s 720 7 /q- 52?- <br />/ <br />Permittee Company: <br />Address: <br />77/ /i - •airy rz <br />.5744/6F/C <br />Phone Number: <br />7r,- sseJ -4s 2. <br />Fax Number: <br />7/ 9 - 5 23 -‘' <br />Email Address: <br />h aCCZ cOStra1 /6 i4 cc;, COON /V. /vd'T <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. <br />15. Is adequate topsoil reserved for reclamation, based on your approved permit? <br />If "NO ", please explain: <br />16. Is the reserved topsoil vegetated /stabilized in accordance with Rule 3.1.9(1)? <br />If "NO" please explain: <br />18. Are all hazardous materials stored within approved spill containment structures? <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? <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 />Signature of Corporate Officer, Owner, or Documented Designee <br />YES <br />NO N/A <br />NO N/A <br />17. If mining has exposed groundwater, is the site in compliance with the approved mining plan and Office o <br />State Engineer (Well Permit, S.W.S.P., and /or Permanent Augmentation Plan)? YES NO <br />YES NO <br />NO N/A <br />NO <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 i . , cordance with the Division approved mining and reclamation plans. <br />/ 1 /d <br />Dat <br />N/A <br />