2011-11-21_REPORT - M2005065

• Permit No: M2005065
• IBM Index Class Name: REPORT
• Doc Date: 11/21/2011
• From: Jack Clark Jr
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

13. Attach a map to this report that accurately depicts the permit boundary, current affected area boundary and
location of the acreages specified in Items 7 -12 and 14. Please check the appropriate response below:
UPDATED MAP ATTACHED: CONDITIONS UNCHAGED - PREVIOUS MAP ACCURATE:
14. Is weed control being conducted in accordance with an approved Weed Control Plan? () NO N/A
If "YES ", indicate the weed species, ; ntrol•area, control tyke, application rate and treatment date on the
report map. 190 /4)E'e.,9 pire.e.5 ��� -af
15. Is adequate topsoil reserved for reclamation, based on your approved permit? NO N/A
If "NO", please explain:
16. Is the reserved topsoil vegetated/stabilized in accordance with Rule 3.1,9(1)? 65) NO N/A
If "NO" please explain:
-17. If mining has exposed groandwater,.is the site in plianee.wIth the approved mining and Office of the
State Engineer (Well Permit S.W.S.P., and/or Permanent Augmentation Plan)?
X e l dolts ilnat s stored with n p roved spill containme�rt strrxdures? YES NO
19. Is your financial warranty value sufficient to cover the cost to complete reclamation? 1 1E7 NO N/A
20. Is your basis for legal right to enter is still valid? NO
21. Does your permit require you to submit monitoring information annually?
If "Yes", please attach the required monitoring results to this annual report.
Please provide current contact Information:
Date
YES
NO N/A
N/A
I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site
operations are being conducted in accordance with the Division approved mining and reclamation plans.
Asie
P ermittee Contact:
-
LJ ACk cemek -3 g ,
Permittee Company:
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JI ° i N;Oftii, jA1YD
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Address:
3$ /f CovAef Rona
S / /ten for✓, l • 17403
Pa Bog 717
Phone Number:
970 - 387 -.5243
Fax Number:
r7o 9. 317 - 61?!
Email Address:
J12 8/ 6e lice, Cow
13. Attach a map to this report that accurately depicts the permit boundary, current affected area boundary and
location of the acreages specified in Items 7 -12 and 14. Please check the appropriate response below:
UPDATED MAP ATTACHED: CONDITIONS UNCHAGED - PREVIOUS MAP ACCURATE:
14. Is weed control being conducted in accordance with an approved Weed Control Plan? () NO N/A
If "YES ", indicate the weed species, ; ntrol•area, control tyke, application rate and treatment date on the
report map. 190 /4)E'e.,9 pire.e.5 ��� -af
15. Is adequate topsoil reserved for reclamation, based on your approved permit? NO N/A
If "NO", please explain:
16. Is the reserved topsoil vegetated/stabilized in accordance with Rule 3.1,9(1)? 65) NO N/A
If "NO" please explain:
-17. If mining has exposed groandwater,.is the site in plianee.wIth the approved mining and Office of the
State Engineer (Well Permit S.W.S.P., and/or Permanent Augmentation Plan)?
X e l dolts ilnat s stored with n p roved spill containme�rt strrxdures? YES NO
19. Is your financial warranty value sufficient to cover the cost to complete reclamation? 1 1E7 NO N/A
20. Is your basis for legal right to enter is still valid? NO
21. Does your permit require you to submit monitoring information annually?
If "Yes", please attach the required monitoring results to this annual report.
Please provide current contact Information:
Date
YES
NO N/A
N/A
I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site
operations are being conducted in accordance with the Division approved mining and reclamation plans.
Asie