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Pe11111t n - L1 <br />According to (1.R S. 31- .-12.5- I 1 o or 3'1 -.5 -I 16, each vear, on the anniversary S ite of the permit, ali opereloi r11<SS1 <br />submit the annual fee, an annual report and map showing the extent of disturbances to affected land, <br />required monitoring information, reclamation accomplished to date and during the preceding year, any new <br />disturbance that is anticipated to occur during the upcoming year, any reclamation that will be perfUr111cd dui <br />the upcoming year, the dates for the beginning of active operations, and the date active operations ceased tot' the <br />year, if any. <br />Information contained in this report will be reviewed by the Division upon receipt and prior to the next coniplian e <br />inspection of the site. If, while completing this report, you learn that your site is not in compliance with the rules <br />and the act, it is advisable that the issues be rectified promptly to avoid possible enforcement action <br />1. Is the site identification sign posted in accordance with Rule 3.1.12(1) (YES) NO <br />2. Is the affected area boundary clearly marked in accordance with Rule 3.1.12(2) <br />3. Is the mine site in final reclamation (all material extraction and stockpile removal i <br />If "YES," please note time limits related to completion of reclamation, Rule 3.1.3. <br />4. What was the date of last excavation, processing or hauling activity at the mine? 0 /? <br />3. Does the mine operate more or less than 180 days per year? <br />If "LESS ", please review Rule 1.13 to assure that your mine is in compliance. <br />6. Has this mine been granted: a) approval of TEMPORARY CESSATION Status? <br />b) approval for INTERMITTENT OPERATION? <br />7 . Number of acres currently affected (mining + incomplete and or unreleased reclamation) <br />8. <br />Number of acres that were newly affected during the current report year. �' S <br />0. Number of acres that were reclaimed during the current report year <br />1 O Estimated new acreage to be affected in the liext report year. j S <br />11. Estimated <lei is to lie reclaimed in the next report year <br />I '. Total a'il`s in i ' , 1 1 I n t l 1 ; l ip of m r ' c l , l i l l a t i o n , ti i i o e i)ei untied mining ac t cities h(te).ill <br />Total acres <br />Total acres <br />adixd• <br />Seed <br />,ippli'_atioll <br />method. <br />7 <br />Total acres <br />seeded ■v <br />approved l 1111\' <br />Total acres <br />fertilized w j <br />aped fertilizer: J- - <br />Fertiliizer <br />appliratioil <br />method: <br />Annual Report <br />Total. acres <br />n /topsoil <br />reglat ed' <br />Topsoil <br />replacement <br />depth (in ). <br />S ikh <br />application <br />m etboci <br />YE NO <br />s complete)? YES NO <br />// <br />Total ,li'1'c <br />mulched k ,, <br />approved milt i1 <br />Mulch application <br />rate (tons) <br />MORE <br />YES <br />/['ES <br />7 <br />NO <br />