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Permittee Contact: <br />7 a O ec , K -t r` <br />Permittee Company: <br />E/ a- or f7 ? <br />h -rNc . <br />Address: <br />5 f ru7 - h er-s <br />N4 0,.� /J �vYI 7 vel G O <br />v e. <br />S' /J �f <br />Phone Number: <br />? Jv - .l y A- 53 7 v <br />Fax Number: <br />970 ,2 Y.r_ 77) 6 <br />Email Address: <br />7- odc.P. b e r. v tr Z e /a., <br />C. o h sf yi c! C Zec s-1, e a w, <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: <br />ignature o <br />Please provide current contact information: <br />orate i fficer, 0 er, or Documented Designee <br />CONDITIONS UNCHAGED - PREVIOUS MAP ACCURATE: <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 />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. <br />ES NO N/A <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)? NO N/A <br />18. Are all hazardous materials stored within approved spill containment structures? ES NO N/A <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? d.5� NO N/A <br />20. Is your basis for legal right to enter is still valid? <br />NO N/A <br />NO <br />21. Does your permit require you to submit monitoring information annually? YES N/A <br />If "Yes ", please attach the required monitoring results to this annual report. <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 />/y XI <br />Date <br />