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Permittee Contact: <br />q6r4 f <br />Permittee Company: <br />Lev54 Wc_9 <br />J <br />Address: <br />( 0 l9 G1iV1- -1, [Z t•L <br />WC-5 CM It- .5TV 63 Oez> <br />- <br />Z <br />( <br />Phone Number: <br />(3 (4-4.-4-- _ 4 6-1-"t <br />Fax Number: <br />Email Address: <br />F *Ee_; ,-1 egac - NIA, coM <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? NO N/A <br />If "YES ", indicate the weed species, control area, control type, application rate and treatment date on the <br />report map. (2 ■rvf£ts] l -T`i 1 - ' walp L-T5 j <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)? CD NO N/A <br />If "NO" please explain: <br />17. If mining has exposed groundwater, is the site in compliance with the approved mining p <br />State Engineer (Well Permit, S.W.S.P., and /or Permanent Augmentation Plan)? <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 />1217 - / <br />Signature of Corporate Offi wner, or Documented Designee Date <br />CliD NO N/A <br />nd Office of the <br />NO N/A <br />NO N/A <br />NO N/A <br />NO <br />NO 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 />