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Permittee Contact: <br />r 2-k- 0 1 � <br />Permittee Company: <br />t-"F Cv •./C-57 <br />Address: <br />VA4 ' t'-%4 VariC - <br />WP lI 51.c.- z .) <br />WE.5 A J9 (-- C a (x)Z <br />i <br />Phone Number: <br />3> 605 '' <br />(3.-,3) _ <br />Fax Number: <br />Email Address: <br />C-qc�l 'FAA C$ LAF <br />-(vv4 ,0(‘-‘ <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 type, application rate and treatment date on the <br />report map. rev- i=1:(rC2LE G ; - 1 oy r oc <br />N£E r , L p 2 ‘21.5/4 �- F4j1j4 c5-1114-- <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 />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 />Signature of Corporate O wner, or Documented Designee <br />\ I <br />Date <br />YES NO N/A <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 /AJ <br />NO N/A <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 being conducted in accordance with the Division approved mining and reclamation plans. <br />