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Permittee Contact: <br />-Z <br />Permittee Company: <br />/ 0„ nt .g r i ck ( wn n i <br />Address: <br />Yol Pt *,,, 1 Iu.:141t. 6,Zx.k,C..0TNii <br />Phone Number: <br />/c i <br />Fax Number: <br />3 03 - 6gt Vi ly <br />Email Address: <br />r/ <br />r°f;l4, s6 it_ ie . Cow, <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? f NO N/A <br />If "YES ", indicate the weed species, control area, control type, application rate and treatment date on the <br />report map 2144 �� I as Le C -.1 cupplir -ta �',;n - Ms-t4 b /(4-, pc,c I` ;�;�yt'4' <br />aVI C4 o2S y ' i`n -Fc k 5 ruyrr .. <br />Yrv, Pick (.4 -4-t 4�•�, �{ rrr ' /70 r at /tr, c-rrEs �r � ti <br />15. Is adequate topsoil reserv for reclama based on your approved permit? Y 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 plan and Office of the <br />State Engineer (Well Permit, S.W.S.P., and /or Permanent Augmentation Plan)? YES NO /A <br />18. Are all hazardous materials stored within approved spill containment structures? YES NO N/A <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? ES NO N/A <br />20. Is your basis for legal right to enter is still valid? ES NO <br />21. Does your permit require you to submit monitoring information annually? YES 6 N/A <br />If "Yes ", please attach the required monitoring results to this annual report. <br />Please provide current contact information: <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 />t/igi <br />Signature of Corporate Officer, Owner, or Documented Designee <br />//ay .2Z 2/ W <br />Date <br />YES NO N/A <br />