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Pe / e 1 Contact: <br />a P , e--1 , 1. t-c--- <br />Permittee Company: <br />Address: <br />dd ess• <br />/ <br />'' <br />5 h,---,_ <br />Z ,.,......, <br />, ‘70 <br />,,, ,•..."1 <br />Phone Number: <br />7/? <br />3 <br />3 <br />L 5 <br />Y,.6. <br />Fax Number: <br />7/ f <br />3 <br />i <br />9 <br />Email Address: <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? 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 pproved permit? <br />If "NO ", please explain: L.,'' hi 14 4, , ° � <br />; I fre, 440,, ,57 ,4 <br />16. Is the reserved topsoil vegetated /stabilized in accordance with Rule 3.1.9(1)? <br />If "NO" please explain: <br />• 17. If mining has exposed groundwater, is the site in compliance with the approved mining plan and Office o <br />- State - Engineer- (Well- Per -mit, S -WS P. /or- Permanent Augmentation -Plan)? - NO <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? <br />20. Is your basis for legal right to enter is still valid? <br />YES <br />21. Does your permit require you to submit monitoring information annually? YES . NO <br />If "Yes ", please attach the required monitoring results to this annual report. <br />Please provide current contact information: <br />NO <br />NO <br />cts7,0 <br />I, the undersigned, hereby state that the information provided in this report is true andaccurate, and that site <br />operations re beim conducte4 in accordance with the ivision approved mining and reclamation plans. <br />Signature of orporate Officer, Owner, or Documented Designee Date <br />