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Permittee Contact: <br />I [� <br />R c�ndo�/ l l 4rrcJJ� <br />5ut. cie 6;0,,, / ka <br />a2 3-al S 1,4el <br />/l/� c <br />KO r C � L.' , C ' f `)c2N'1 <br />' <br />r' �,5 <br />e re // i/ <br />Permittee Company: <br />Address: <br />Phone Number: <br />Fax Number: <br />Email Address: <br />roa rr-el ", Jr> (P,S iciache_COGifr -IY _ C©, c eh/ f_SSC1 niora cierdcAe CP 4 "CO,ih <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? YES 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 />_ _ <br />Signature of Corporate Officer, Owner, or Documented Designee <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/ <br />If "NO" please explain: <br />17. If mining has exposed groundwater, is the site in compliance with the approved mining plan and Office 61,the <br />State Engineer (Well Permit, S.W.S.P., and /or Permanent Augmentation Plan)? YES NO N/A <br />18. Are all hazardous materials stored within approved spill containment structures? YES NO <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? YES NO N%A <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 />I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site <br />oper ons are being conducted in accordance with the Division approved mining and reclamation plans. <br />Date <br />N/A <br />