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Permittee Contact: <br />Permittee Company: <br />Address: <br />1 CI P 1 — i ± - ' ic1 <br />tn//8'1 1 5 PE 1 <br />4.45 S'MDJ S i <br />="' <br />Phone Number: <br />C ;'S1 G5 _4 <br />Fax Number: <br />Email Address: <br />412T-, 1 e LAF-APc . 10,4 <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? 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. rttz G.»t.i / •0y -1.»5. wt_ L <br />or' - Cx,,: - r - v A s NE <br />15. Is adequate topsoil reserved for reclamation, based on your approved permit? S NO N/A <br />If "NO ", please explain: <br />16. Is the reserved topsoil vegetated /stabilized in accordance with Rule 3.1.9(1)? YE NO N/A <br />If "NO" please explain: <br />17. If mining has exposed groundwater, is the site in compliance with the approved mining 1 n and Office of the <br />State Engineer (Well Permit, S.W.S.P., and /or Permanent Augmentation Plan)? E) NO N/A <br />20. Is your basis for legal right to enter is still valid? <br />Please provide current contact information: <br />Signature of Corporate Officer, vne }, or Documented Designee Date <br />18. Are all hazardous materials stored within approved spill containment structures? YES NO N A <br />Nvr or-) ' . <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? ES NO N/A <br />YES NO <br />21. Does your permit require you to submit monitoring information annually? YES NO N/A <br />If "Yes ", please attach the required monitoring results to this annual report. <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 />