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Permittee Contact: <br />6Le N JO_ 6117 uS <br />Permittee Company: <br />Address: <br />7y ( ✓net , - s7` <br />Pr. iLO/ F,Q[ ,LR <br />g /3 <br />Phone Number: <br />7/ l S`_- 3 6552. <br />Fax Number: <br />7(9 -52 3- 65 &4 <br />Email Address: <br />1 aC- cv. r7n" / hetc‘t e.i2c4 Ajt ti T <br />a <br />13. Attach a map to this report that accurately depicts the permit boundary, current affected area boundary and i <br />location of the acreages specified in items 7- 12 and 14. Please check the appropriate response below: , ,7 <br />UPDATED MAP ATTACHED: CONDITIONS UNCHAGED - PREVIOUS MAP ACCURATE: Y <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 the <br />report map. <br />15. Is adequate topsoil reserved for reclamation, based on your approved permit? <br />If "NO ", please explain: <br />NO N/A <br />16. Is the reserved topsoil vegetated /stabilized in accordance with Rule 3.1.9(1)? YES NO N/A <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 N/A) <br />18. Are all hazardous materials stored within approved spill containment structures? YS NO , N/A) <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? \'ES NO N/A <br />�t J <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? YES CNO) N/A <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 />Signature of Corporate Officer, Owner, or Documented Designee <br />Date <br />