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Permittee Contact: <br />Ye- RiTIC -1 ? - t = j — <br />Permittee Company: <br />/ " ", t <br />7/ <, e CnCi - e l 1 .:, <br />Address: <br />eCy 2q9 <br />Phone Number: <br />( C • 6;627 2( eo <br />Fax Number: <br />Email Address: <br />fe e f& 61Q4 cznelf IC, ( <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? YES / 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? <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 <br />State Engineer (Well Permit, S.W.S.P., and /or Permanent Augmentation Plan)? <br />18. Are all hazardous materials stored within approved spill containment structures? <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` NO N/A <br />YES NO N/A <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? ' E NO N/A <br />20. Is your basis for legal right to enter is still valid? YES } NO <br />I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site <br />operations are •eing conducted in accordance with the Division approved mining and reclamation plans. <br />, - ,Ze/ Z <br />Signa ura orporate Officer, Owner, or Documented Designee Date <br />and Office of the <br />NO N/A <br />NO N/A <br />NO N/A <br />