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Permittee Contact: <br />gowARS rnk6irvivis <br />7Rju,c k Acrd rn;t iig/q ftva "mow <br />Permittee Company: <br />y an" 11 Ca41077 <br />Ro/td Awe) jR;c16E <br />Address: <br />/3' )O 3aaTY $0AKr' Sr, <br />WRN7 col() <br />&o7sg <br />Phone Number: <br />970- 33Z- 7 /8 <br />Fax Number: <br />q7v Z 'yZ 1 <br />Email Address: <br />, h0 to et Aa/ye CE /vrony ree onJFT <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. 1 No /b <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)? <br />If "NO" please explain: <br />17. If mining has exposed groundwater, is the site in compliance with the approved mining plan and Office of the <br />__State_Engineer (We11,Per_mit,_S,W.S.P_., and /_or_Permanent.Augmentation Plan)_ <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 />Please provide current contact information: <br />944V 4, <br />Signature of Corporate Officer, Owner, or Documented Designee <br />JO <br />Date <br />NO N/A <br />NO N/A <br />NO N/A <br />NO <br />21. Does your permit require you to submit monitoring information annually? YES NO N/A <br />If "Yes ", please attach the required monitoring results to this annual report. <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 />