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Permittee Contact: <br />Dan Kehn <br />Permittee Company: <br />Don Kehn Construction, Ins. <br />Address: <br />6550 South County Road 5 <br />Ft. Collins, CO 80528 <br />Phone Number: <br />970- 226 -4111 <br />Fax Number: <br />970 -226 -4115 <br />Email Address: <br />kehn @longspeak . ent <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: X CONDITIONS UNCHAGED - PREVIOUS MAP ACCURATE: <br />14. Is weed control being conducted in accordance with an approved Weed Control Plan? YES j 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 />16. Is the reserved topsoil vegetated /stabilized in accordance with Rule 3.1.9(1)? <br />If "NO" please explain: <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 />Vices Q <br />Signature of Corporate Officer, Owner, or Documented Designee <br />2/24/12 <br />Date <br />YES j NO N/A <br />NO N/A <br />17. If mining has exposed groundwater, is the site in compliance with the approved mining nd Office of the <br />State Engineer (Weil Permit, S.W.S.P., and /or Permanent Augmentation Plan)? Y• NO N/A <br />18. Are all hazardous materials stored within approved spill containment structures? ( YES , 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 />YES <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 />N/A <br />