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Permittee Contact: <br />n/� // /I //�� II II <br />R 2nola/ g 4rre,,Li cio <br />Or /vte_ iLl �oZr,6 ra <br />Permittee Company: <br />r �D <br />S �G c - oc 1 C)(/4 le)6c1 <br />1 / <br />V yJ! I dG�C� <br />Address: <br />J <br />36) 3r° `. ci 4/. die= <br />J <br />Cr) ,.s?'// <br />Phone Number: <br />Fax Number: <br />/9- 66 <br />Email Address: <br />�^cc)i rre�O,r Jo e_ 50_4-v7cl,e <br />/ <br />r�JV,. -CYO, � 0 v es.c.34/0 ra. sa,�'u „ch. ,. C6Jet 4 <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 />CONDITIONS UNCHAGED - PREVIOUS MAP ACCURATE: <br />14. Is weed control being conducted in accordance with an approved Weed Control Plan? �( ) 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 GI/AD <br />If "NO" please explain: <br />- y 17°If mining has exposed"ground - ware r -- i"s the site in compliance with the approved rriinng plan and Office <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? YES NO N/A <br />YES NO <br />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 />I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site <br />operat'ons are b • conducted in accordance with the Division approved mining and reclamation plans. <br />I e <br />Signature of Corporate Officer, Owner, or Documented Designee Date <br />NO N/A <br />NO N/A <br />