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Permittee Contact: <br />I)1%cttA£ Loftt c9AleA) <br />Permittee Company: <br />pp C <br />Lo vo�leN D 'o5 -TT-o,? LOrn/>AN7 <br />Address: <br />1 f /J, -V 03iW «5 <br />Lo,N)G - 1 Co . SoSGS <br />(iwy <br />Phone Number: <br />3 -e'23 - 6. 2C,eg <br />Fax Number: <br />�0 5 - 6 - 2 3 - 66M 7 <br />Email Address: <br />tIADL_LKS CA? t,ty2.7gl-VM . Ate J <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: A7 <br />14. Is weed control being conducted in accordance with an approved Weed Control Plan? (yE-s NO N/A <br />If "YES ", indicate the weed species, control area, control type, application rate and treatment date on the <br />report map. VC/4 Wen) Gee rv,,ot' ) SNR,a•,AJG APPLtcATltorl 10 Pe 'Desutm dT Tim aF 5Fk6y1616 <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)? 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)? DES NO N/A <br />18. Are all hazardous materials stored within approved spill containment structures ? Si NO N/A <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? (IRS) NO N/A <br />20. Is your basis for legal right to enter is still valid? (YE E NO <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 />YES 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 />�r4/!�— 7 �i' - /- /0 - /Z <br />Signature of Corporate Office f, Owner, or Documented Designee Date <br />