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Permittee Contact: <br />/f/t/ite A .„.. #- <br />Permittee Company: <br />Q / / 5'• ,,z) ed .' <br />"t <br />Address: <br />/�, p x ,7 7G SO <br />/� ww sWS s re)/e <br />3 <br />3 <br />Phone Number: <br />7/9 -5 -5787 <br />Fax Number: <br />-7/ g_ c99- 75:09 <br />Email Address: <br />.� <br />yi�/e� e 'e n 4.-, -.A0/, Ger- <br />/Awe <br />1 . <br />13. Attach a map to this report that accurately depicts the permit boundary, current affected area boundary and location of <br />the acreages specified in items 7- 12 d 14. Please check the appropriate response below: <br />UPDATED MAP ATTACHED: ,1 CONDITIONS UNCHANGED - PREVIOUS MAP ACCURATE: <br />14. Is weed control being conducted in accordance with an approved Weed Control Plan? <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 a <br />Engineer (Well Permit, S.W.S.P., and/or Permanent Augmentation Plan)? <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 />Signature of Corpor Officer, Owner, or Documented Designee <br />If "YES ", indicate the weed species, control area, control type, application rate and treatment .ate on the report map. <br />9/ V/ 7- <br />Date <br />18. Are all hazardous materials stored within approved spill containment structures? ® NO N/A <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? NO N/A <br />20. Is your basis for legal right to enter still valid? NO <br />YES <br />NO N/A <br />NO N/A <br />NO N/A <br />fice of the State <br />NO N/A <br />N/A <br />Division records indicate the following permittee contact information. If this information is not current, please type or <br />print current contact information: <br />I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations <br />are being conducted in accoyd pce with the Division approved mining and reclamation plans. <br />