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Permittee Contact: <br />Richard Coulson, CEO <br />Permittee Company: <br />Coulson Excavating Co, Inc <br />Address: <br />— _ -- — <br />3609 North County Rd 13 <br />Loveland,. Co._80538__ <br />-- -- <br />Phone Number: <br />970 - 667 -2178 <br />Fax Number: <br />970 - 667 -2193 <br />Email Address: <br />diana@coulsonex.com <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: X <br />14. Is weed control being conducted in accordance with an approved Weed Control Plan? 'E 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)? YES NO N/A <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 (Well Permit,S:W:S:P., an or erma nt Aumenta o <br />18. Are all hazardous materials stored within approved spill containment structures? YE NO N/A <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? NO N/A <br />20. Is your basis for legal right to enter is still valid? NO <br />YES NO N/A <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 />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 />ita- <br />Signature of Corporate Officer, Owner, or Documented Designee <br />Diana Moneypenny, Secretary <br />Nov. 15, 2011 <br />Date <br />NO N/A <br />