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Permittee Contact: <br />m cavil 2 k yl <br />Permittee Company: <br />Cat d G24(e. sip," G vc, i (n <br />G. c(b 2 .I%ou V cor <br />fTz✓ r <br />f 5 <br />Address: <br />P.o. Box 1 ) GS <br />Batil¢1c1 i ( b I( <br />Phone Number: <br />1 570 • 247 - 2172 <br />Fax Number: <br />970 .259. 3631 <br />Email Address: <br />WIG ✓ na.k2n @ 4- Cav✓le✓<_ <br />ill ls- 2✓ Lan <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 and 14. Please check the appropriate response below: / <br />UPDATED MAP ATTACHED: CONDITIONS UNCHANGED - PREVIOUS MAP ACCURATE: t <br />14. Is weed control being conducted in accordance with an approved Weed Control Plan? <br />If "YES ", indicate the weed species, control area, control type, application rate and treatment <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 />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 Corporate Officer, Owner, or Documented Designee <br />4 /23/12 <br />Date <br />NO N/A <br />ate on the report map. <br />'E3 NO N/A <br />9 NO N/A <br />17. If mining has exposed groundwater, is the site in compliance with the approved mining plan and Office of the State <br />Engineer (Well Permit, S.W.S.P., and/or Permanent Augmentation Plan)? YES NO <br />18. Are all hazardous materials stored within approved spill containment structures? <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 still valid? NO <br />YES N/A <br />NO 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 ac%ordan with the Division approved mining and reclamation plans. <br />