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Permittee Contact: <br />Permittee Company: <br />p Jam` - v , 1 F'� <br />,\ <br />LL c____ <br />Address: <br />•b C i, ` U <br />Si tW. - r - .k -{. 047 i CO <br />4 <br />� � <br />Phone Number: <br />Fax Number: <br />Email Address: <br />7) <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 />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 treatme date on the <br />report map. fir, (itli . v) ,.5;� A,;.4 1 NA lJ y 4 , ( ✓` , 1 , C-f - 1,--') c ( <br />()-�pk ( L-�;J L�vtA F i <br />15. Is adeq ate topsoil reserve'd for reclamation, base 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 />17. If mining has exposed groundwater, is the site in compliance with the approved mining pl <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? ES NO N/A <br />19. Is your financial warranty value sufficient to cover.the cost to complete reclamation? YES NO N/A <br />20. Is your basis for legal right to enter is still valid? (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 />Please provide current contact information: <br />CONDITIONS UNCHAGED - PREVIOUS MAP ACCURATE: <br />NO N/A <br />nd Office of the <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 />° <br />ature of Corpora icer, Owner, or Documented Designee Date <br />