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Permittee Contact: <br />y 4 , <br />Permittee Company: <br />r <br />, _ ` �: y 7,/,: , v ° <br />r , r , : -� <br />r <br />Address: <br />i '', i.: ---,) ,,, C r yip )" e4 <br />(., 7 ? -tc: v 1„. T1: - : Le rr t <br />Phone Number: <br />(- : - -•7 i , — , .j - <br />Fax Number: <br />Email Address: <br />„ - _� <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 treatment date on he <br />report map. ' f lr.r f , /i }z - l' /1 11 7„ 1 `5/,41ii % ,> , ..,� e;'rip7, ∎:,'.<1 t 7 , ,, rlr, b � /w7" <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)? E NO N/A <br />18. Are all hazardous materials stored within approved spill containment structures? NO N/A <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? YES NO N/A <br />YES NO <br />21. Does your permit require you to submit monitoring information annually? YES NO N/A <br />If "Yes ", please attach the required monitoring results to this annual report. <br />Please provide current contact information: <br />20. Is your basis for legal right to enter is still valid? <br />YES NO N/A <br />�ES NO 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 />Signature of Corporate Officer, Owner, or o men Designee Date/ <br />