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Permittee Contact: <br />eqK <br />Permittee Company: <br />).--._ usz vk <br />rt <br />Lit ( - 11 --t ' <br />Address: <br />Phone Number: <br />9 qe) ,2_ <br />3 <br />+.s 3-9 <br />Fax Number: <br />ci ID S Z- 2 - L i (-) I 8 <br />Email Address: <br />tz k e <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 />14. Is weed control being conducted in accordance with an approved Weed Control Plan? YES <br />If "YES ", indicate the weed species, control area, control type, application rate and treatment datee on the <br />report map. <br />15. Is adequate topsoil reserved for reclamation, based on your approved permit? (YES) 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 />Signatur of Corporate Office or Documented Designee <br />UPDATED MAP ATTACHED: <br />CONDITIONS UNCHAGED - PREVIOUS MAP ACCURATE: <br />17. If mining has exposed groundwater, is the site in compliance with the approved mining plan and Office <br />_State_Engineer- (Well- Permit, S.W. -S:P., and/or Permanent Augmentation Plan)? YES NO (N / A i <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 />YES <br />�G N &1) 1J <br />Date <br />NO N/A <br />NO <br />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 beir j coil ud t accordance with the Division approved mining and reclamation plans. <br />