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Permittee Contact: <br />Matt Muller <br />Permittee Company: <br />Siloam Stone, Inc <br />Address: <br />315 N. 7th Street <br />Canon City, CO 811012 <br />Note: <br />Review attached page for details <br />on current mine status and uses. <br />Phone Number: <br />(719) 275 -4275 <br />Fax Number: <br />(719) 275 -9050 <br />Email Address: <br />info @siloamstone.com <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 n <br />UPDATED MAP ATTACHED: I 1 CONDITIONS UNCHAGED - PREVIOUS MAP ACCURATE: re I <br />14. Is weed control being conducted in accordance with an approved Weed Control Plan? YES ) DrOti. <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? YES XM Me <br />If "NO ", please explain: <br />16. Is the reserved topsoil vegetated /stabilized in accordance with Rule 3.1.9(1)? YES XVI KM <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)? X95 Xt@ N/A <br />18. Are all hazardous materials stored within approved spill containment structures? YES fie( X* <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? YES xoc X)� <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 />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 />- � '� /keew,v e r — Signature .f Corporate Offic wner, or Documented Designee Date <br />YES X <br />)036 VG N/A <br />