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Permittee Contact: <br />D 7/7 /ir- <br />Permittee Company: <br />NA _ <br />Address: <br />P b C /e. yt Perk- 0 <br />Crat ,y ?2 g/Y/s <br />Phone Number: <br />970_ 9 /- 6 - a 9 9 <br />Fax Number: <br />970-9A/ -5 / <br />Email Address: <br />Pe /1/D tms h 7 r � lea .se 7 <br />;S <br />%n1r/nu fof - <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: X 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. S ee J'/© A <br />15. Is adequate topsoil reserved for reclamation, based on your approved permit? NO N/A <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 <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? <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamatio <br />20. Is your basis for legal right to enter is still valid? <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 />Signature of orporate Officer, Owner, or Documented Designee Date <br />YES NO <br />YES <br />NO N/A <br />NO <br />YES 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 a e being conducted] accorda ce wit the Division approved mining and reclamation plans. <br />0.2/c.z <br />NO N/A <br />