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Permittee Contact: <br />�N Fotifq, j vS.A r Fi el) <br />Permittee Company: <br />Address: <br />Phone Number: <br />Fax Number: <br />Email Address: <br />nh) v - es.,to@ Comea4 , <br />ct_, ) este /Ca eife /or I. CO Id"- <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 UNCI-IAGED - PREVIOUS MAP ACCURATE: '1 <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 />15. Is adequate topsoil reserved for reclamation, based on your approved permit? YES NO <br />If "NO ", please explain: <br />16. Is the reserved topsoil vegetated /stabilized in accordance with Rule 3.1.9(1)? YES NO <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 e <br />State Engineer (Well Permit, S.W.S.P., and /or Permanent Augmentation Plan)? YES NO N/ <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? <br />20. Is your basis for legal right to enter is still valid? <br />Please provide current contact information: <br />NO N/A <br />NO N/A <br />NO <br />21. Does your permit require you to submit monitoring information annually? YES (ID) N/A <br />If "Yes ", please attach the required monitoring results to this annual report. <br />1, 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 />eusu, cc.c Anoi6 <br />8y a,LG. <et 'et I ,,,W1166& <br />Signature of Co or e O r , Owner, or Documented Designee Date <br />