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Permittee Contact: <br />J 0 Se i-'N C t. c <br />Permittee Company: <br />Svrv►n. , r i'a e . i cf� q- <br />v r L (: (xa.7Y 17- A ' Y <br />Address: <br />P. o, tL o x 5> i <br />. �i`: , 4 , co r l o? <br />o `_ <br />Phone Number: <br />7 i 9_ 5/Z _ 8? 7 g <br />Fax Number: <br />Email Address: <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 />in <br />UPDATED MAP ATTACHED: /� CONDITIONS UNCHAGED - PREVIOUS MAP ACCURATE: <br />14. Is weed control being conducted in accordance with an approved Weed Control Plan? NO N/A <br />If "YES ", indicate the weed species, control area, control type, application rate and treatment date on the <br />report map. N 0 00 x a ov t....,K, €"t) <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 plan and Office of the <br />State Engineer (Well Permit, S.W.S.P., and /or Permanent Augmentation Plan)? YES NO <br />18. Are all hazardous materials stored within approved spill containment structures? YES NO <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? YES NO N/A <br />20. Is your basis for legal right to enter is still valid? YES) 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 />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 />(- <br />Signature of Corporate Officer, Owner, or Documented Designee <br />D to <br />ES ) NO N/A <br />YES <br />NO N/A <br />N/A <br />