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Permittee Contact: <br />V s <br />3 vim_ 1` LAS ` <br />�? <br />Est vy , +-14. 0n��I `} -Gl v t v on -Q ✓., ( � c.in.t 5 <br />Permittee Company: <br />C- Vne_ JJirov\ Vi e_Ot<co <br />Address: <br />760 /-/vrtzvv, Dr( rre, <br />G . ra vice 3 tmic_A-; ov\ , e° CU 1 500 <br />Phone Number: <br />6 170 - 57 — Ze 64 7a <br />Fax Number: <br />q70 _045 — / <br />Email Address: <br />I DA 4LA s Lhs tlrOti . 0001 <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: V CONDITIONS UNCHAGED - PREVIOUS MAP ACCURATE: <br />14. Is weed control being conducted in accordance with an approved Weed Control Plan? ® 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? <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 />1 If mining -has exposed groundwater, is the site in cmapliance with the approved mining plan and Office o <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? <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 />V `J <br />I, 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 />u_. <br />SignatuYe of Corporate Officer, Owner, or Documented Designee Date <br />NO N/A <br />NO N/A <br />YES NO N/A <br />NO N/A <br />NO <br />YES NO N/A <br />