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Permittee Contact: <br />Ma\- -\ i (A -c c rrc: 6 p <br />Permittee Company: <br />fr A , Cane re * -- CO PS`*Ir w�` o 9 111C- . <br />Address: <br />023 a3 ( ,v-Q.r Qba& <br />G CO ---\ u ��,c 6 rV. , C. d R`15 OS <br />Phone Number: <br />C. -1 O` al 1 4 3- 3c2_,a I <br />Fax Number: <br />n <br />C G\70 )9 -1- � _ cl <br />Email Address: <br />ryl ct,concre. arnG - nda, @ ,2 resri c.n , rL-2+' <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? DES/ 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 />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 />Signdture of Corp ate 0 icer, Owner, or Documented Designee Date <br />NO N/A <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 />-- minirrg - s exposed "gro`und water, the site m compliance with the approved minin :. ' •and Office of the <br />State Engineer (Well Permit, S.W.S.P., and /or Permanent Augmentation Plan)? NO N/A <br />NO N/A <br />NO N/A <br />la NO <br />YES 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 />117)) <br />