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Permittee Contact: <br />—4S 4i 4 . Do✓'r; <br />Permittee Company: <br />&144- es psi( , -� G ��s if-e <br />--/ e,..11.5 <br />Address: <br />Z 9 yc? Cade;- tf fs 67 <br />Cdr J0i S 67-e, y4 q <br />Phone Number: <br />( b g ._ � <br />Fax Number: <br />Email Address: <br />- <br />�' /G1 CO� k l a � ;\'lYl/LclC:> /H i'/liImf ,S . t,emi <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: t CONDITIONS UNCHAGED - PREVIOUS MAP ACCURATE: <br />14. Is weed control being conducted in accordance with an approved Weed Control Plan? YES NO N/r) <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? 4 NO N/A <br />If "NO ", please explain: <br />16. Is the reserved topsoil vegetated /stabilized in accordance with Rule 3.1.9(1)? 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? YES NO ® _ <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? ES NO N/A <br />20. Is your basis for legal right to enter is still valid? NO <br />21. Does your permit require you to submit monitoring information annually? YES C 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 c ducted in accordance with the Division approved mining and reclamation plans. <br />7 <br />Signature of rporate Officer, Owner, or Documented Designee Date <br />I d Mme` 1 Z--- <br />