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Permittee Contact: <br />to /Cs•/A d 4 <br />Permittee Company: <br />/QlD 'e- <br />Address: <br />epg5 e, „ ,eergb /3 <br />.49,v unt , et? <br />Phone Number: <br />910 — /r4 -4 <br />Fax Number: <br />Email Address: <br />NO <br />r <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: <br />14. Is weed control being conducted in accordance with an approved Weed Control Plan ?OYES NO N/A <br />If "YES ", indicate the weed species, control area, control type, application rate and treatment date on the <br />report map. s.my,eej 7 Hr S G C ' ,e0 E /S ✓<Aeoeech <br />Ore /kO& <br />15. Is adequate topsoil reserved for reclamation, based on your approved permit? (ESJ 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 NO N/A <br />If "NO" please explain: <br />17 _If mi.ning_ has_ exposed- graundwater. the- site ' e 41e -a in uvethrrin rig- plan = and =O: aff ce-o <br />State Engineer (Well Permit, S.W.S.P., and /or Permanent Augmentation Plan)? YES NO <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? YES N/A <br />If "Yes ", please attach the required monitoring results to this annual report. <br />Please provide current contact information: <br />CONDITIONS UNCHAGED - PREVIOUS MAP ACCURATE: <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 in accordance with the Division approved mining and reclamation plans. <br />Signature of Corpora t fficer, Owner, or Documented Designee <br />Da e <br />