2012-01-13_REPORT - M1977140

• Permit No: M1977140
• IBM Index Class Name: REPORT
• Doc Date: 1/13/2012
• From: Mathias Concrete
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

Permittee Contact:
J --
Permittee Company:
` / v
Address:
/ SG%e9 /!4 a 7 C -Erof v °c
2 4? x* L'/ fix) ,
Phone Number:
( 5......._ 37,2..
Fax Number:
Email Address:
13. Attach a map to this report that accurately depicts the permit boundary, current affected area boundary and
location of the acreages specified in items 7- 12 and 14. Please check the appropriate response below:
UPDATED MAP ATTACHED. CONDITIONS UNCHAGED - PREVIOUS MAP ACCURATE.
14. Is weed control being conducted in accordance with an approved Weed Control Plan?
If "YES ", indicate the weed species, control area, control type, application rate and trea
report map.
15. Is adequate topsoil reserved for reclamation, based on your approved permit?
If "NO ", please explain:
16. Is the reserved topsoil vegetated /stabilized in accordance with Rule 3.1.9(1)?
If "NO" please explain:
17. If mining has exposed groundwater, is the site in compliance with the approved mining
State Engineer (Well Permit, S.W.S.P., and /or Permanent Augmentation Plan)?
18. Are all hazardous materials stored within approved spill containment structures?
19. Is your financial warranty value sufficient to cover the cost to complete reclamation?
20. Is your basis for legal right to enter is still valid?
Please provide current contact information:
Signature of Corporate Officer, Ow
r, or Documented Designee Date
NO N/A
date on the
operations are being conductein ac • ance with the Division approved mining and reclamation plans.
NO N/A
NO N/A
nd Office of the
NO N/A
NO N/A
NO N/A
NO
21. Does your permit require you to submit monitoring information annually? YES ® N/A
If "Yes ", please attach the required monitoring results to this annual report.
I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site