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I <br />112c Annual Report <br />Permittee Name: <br />Total acres <br />Permit Number: <br />— I C -� <br />Operation Name: <br />Total acres <br />County: <br />backfilled: <br />Annual Fee Due: <br />J ' <br />Anniversary Date: <br />Permit Acreage: <br />mulched w/ <br />Current Bond Amt: <br />According to C.R.S. 34- 32.5 -116 or 34 -32 -116, each year, on the anniversary date of the permit, an operator shall submit <br />the annual fee, an annual report and map showing the extent of current disturbances to affected land, required monitoring <br />information, reclamation accomplished to date and during the preceding year, any new disturbance that is anticipated to <br />occur during the upcoming year, any reclamation that will be performed during the upcoming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Information contained in this report will be reviewed by the Division upon receipt and prior to the next compliance <br />inspection of the site. If, while completing this report, you learn that your site is not in compliance with the rules and the <br />act, it is advisable that the issues be rectified promptly to avoid possible enforcement action. <br />1. Is the site identification sign posted in accordance with Rule 3.1.12(1) <br />2. Is the affected area boundary clearly marked in accordance with Rule 3.1.12(2) <br />3. Is the mine site in final reclamation (all material extraction and stockpile removal is complete)? <br />If "YES," please note time limits related to completion of reclamation, Rule 3.1.3. <br />4. What was the date of last excavation, processing or hauling activity at the mine? <br />5. Does the mine operate more or less than 180 days per year? <br />If "LESS ", please review Rule 1.13 to assure that your mine is in compliance. <br />6. Has this mine been granted: a) approval of TEMPORARY CESSATION Status? <br />b) approval for INTERMITTENT OPERATION? <br />7. Number of acres currently affected (mining + incomplete and or unreleased reclamation) <br />8. Number of acres that were newly affected during the current report year. <br />9. Number of acres that were reclaimed during the current report year. <br />10. Estimated new acreage to be affected in the next report year. <br />11. Estimated acres to be reclaimed in the next report year. <br />12. Total acres in various stases of reclamation, since permitted mining activities began: <br />9 YES NO <br />NO <br />YE S 00 <br />MORE ESS <br />YES <br />YES NO <br />Total acres <br />Total acres <br />Total acres <br />Total acres <br />backfilled: <br />seeded w/ <br />w /topsoil <br />mulched w/ <br />approved mix: <br />replaced: <br />approved mulch: <br />Total acres <br />Total acres <br />Topsoil <br />Mulch application <br />graded: <br />fertilized w/ <br />replacement <br />rate (tons): <br />a vd fertilizer: <br />I <br />I depth (in. <br />