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Permittee Contact: <br />J c. b. • v ,47 / '' z- <br />,17 ) '1)75 <br />Permittee Company: <br />p 44 I ' L /r 4 t-' c' 2 -,r y <br />>A 4. I; v 4.1 4 7C: . <br />Address: <br />/j c X r7 e <br />Phone Number: <br />1 , - j . /- 7 4 74/ <br />Fax Number: <br />J f ` S � / _ " '12. c <br />Email Address: <br />4--,4-4 �,,t -Iv j 4'/. 1 , <br />C I'' ' <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: X CONDITIONS UNCHAGED - PREVIOUS MAP ACCURATE: <br />14. Is weed control being conducted in accordance with an approved Weed Control Plan? YES2 NO N/A <br />If "YES ", indicate the weed species, control area, control type, application rate and treat date on the <br />report map. <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)? t YES NO N/A <br />If "NO" please explain: <br />17. If mining has exposed groundwater, is the site in compliance with the approved mining plan and Office of the <br />State Engineer (Well Permit, S.W.S.P., and /or Permanent Augmentation Plan)? YES NO (N /A) <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 />7 <br />/ / <br />S,ignature,of Corporate Officer, Owner, or Documented Designee Date <br />YES <br />NO N/A <br />NO N/A <br />NO <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 />N/A <br />