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Permittee Contact: <br />_ <br />Permittee Company: <br />F-t gc--)9E W£5 <br />Address: <br />r v t1. �kW(:1.1-K -(.k- <br />ViA,-1 ( < r- 20o <br />tp/ ST(v\si g- i 60 �u�`"' <br />2 1 <br />Phone Number: <br />(3,,) (0 - <br />Fax Number: <br />Email Address: <br />g (24- - '" ,t- <br />_ N/. , C,n,,\ <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 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 typ e, application rate and treatment date on the <br />report map. P{..1 5 'PVC 1'E.R• eo U r,rf No-izaJS <br />2 atS44c.. - tzarkac S -- teW4 , i t "(, SEer <br />15. Is adequate topsoil reserved for reclamation, based on your approved permit? Y'1S) 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 />17. If mining has exposed groundwater, is the site in compliance with the approved mining pl and Office of the <br />State Engineer (Well Permit, S.W.S.P., and /or Permanent Augmentation Plan)? r; _S NO N/A <br />18. Are all hazardous materials stored within approved spill containment structures? YES NO (N /A <br />No tic o NI i r-Tt <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? NO N/A <br />20. Is your basis for legal right to enter is still valid? STS 0�0 -,-0 C7r YES c <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 />Signature of Corporate <br />wner, or Documented Designee Date <br />YES <br />NO N/A <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 being conducted in accordance with the Division approved mining and reclamation plans. <br />