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Permittee Contact: <br />Permittee Company: <br />/-( .1_ )■ 4 9-9•02r# <br />Address: <br />3 O t C ,04 ;c z(. <br />I lkt.tte,,,, 60 8°543 <br />Phone Number: <br />3c.)3 . ) -7.). <br />Fax Number: <br />303 5 - )J.e - 7 <br />Email Address: <br />Y\A�IAOSjv ® - ta <br />• cz „. <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? <br />NO N/A <br />If "YES ", indicate the weed species, control area, control type, application rate and trea m nt date on the <br />report map. <br />15. Is adequate topsoil reserved for reclamation, based on your approved permit? S 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 />NO N/A <br />17. If mining has exposed groundwater, is the site in compliance with the approved mining plan and Office of the <br />-- State Engineer (Well Permit; - S :W:S - P., and/or PermarientAugmentation Plan) ? — NO N /A. <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 />NO N/A <br />NO N/A <br />YES NO <br />YES NO 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 />Signature of Corporate Officer, Owner, or D cument Designee Date <br />