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Permittee Contact: <br />Ac !■ t._)\ E L L- O <br />Permittee Company: <br />w e 5 2 N S L-� n c <br />Address: <br />'F' — 3 v % '3 ■ 9 <br />Phone Number: <br />9 - a a to 3 _ 7_1_1 U <br />Fax Number: <br />`17 ' 4 V 3 Z CZ— <br />Email Address: <br />S`M e. I i a C w S- rvu+ i c 2 <br />t f{ - c .- c.:., 4-, <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 N/A <br />If "YES ", indicate the weed species, control area, control type, application rate and treatment date on thy <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 />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 LN %A] <br />18. Are all hazardous materials stored within approved spill containment structures? NO NO N/A <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? C'Y V NO N/A <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 (___ NC) N/A <br />If "Yes ", please attach the required monitoring results to this annual report. <br />Please provide current contact information: <br />YES NO N/A <br />YE) 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 />1/ i? 3r . <br />Signature d Corporate C3fficev; Owner, or Documented Designee Date <br />