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Permittee Contact: <br />St C v e PO At✓ <br />O v S' / n b s 5 M 0 Ap -Y <br />Permittee Company: <br />h ! � 4 M 0 „it., ;; 1 <br />c_ L C <br />Address: <br />3 0 `f 0 $ _ 1/01 11 E) o s <br />C„ l €i"..-001 / C O <br />g'o,/ 0 <br />I— <br />Phone Number: <br />3 U 3 r 0 6 �q' cr <br />7 <br />Fax Number: <br />3 0 3 r ° 6 ' ? $ <br />Email Address: <br />S p 4 evi e H / 2 i 5 e_ a o/• t U'-• -1 <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 <br />If "YES ", indicate the weed species, control area, control type, application rate and treatment 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 accordantg wit Rule 3.1.9(1)? <br />If "N ",please explain: F r e s h w e S i i 1' a h a i. ois <br />a/'� i10 / o 1 of a s tockp; lE , ii e 7 1 o h .Vos e/, <br />17. If mining has exposed groundwater, is the site in ° cdmpliafi 'with the A�pro eti <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 />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? <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 />YES <br />NO N/A <br />N/A <br />lJ ce4,71 vos � / <br />r _ i s Conr 6ti }� m/7 <br />�nning pl; and Office of the <br />NO N/A <br />NO N/A <br />NO N/A <br />YES 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 are being conducted in accordance with the Division approved mining and reclamation plans. <br />Of el in 9 P /-a- 2 "// 7 // <br />ignature of Corporate Officer, Z er, or Documented Designee Date <br />