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Permittee Contact: <br />Julie Mikulas <br />Permittee Company: <br />Martin Marietta Materials, Inc. <br />Address: <br />1800 N. Taft Hill Road <br />Fort Colins, CO 80251 <br />Phone Number: <br />(970) 227 -4041 <br />Fax Number: <br />(970) 407 -3900 <br />Email Address: <br />CF.PR.email <br />1 1C, : Wl LA4.5 ∎/NA 41;114/6teief . (30y✓k <br />13. Is weed control being conducted in accordance with an approved Weed Control Plan? YES NO /A) <br />If "YES ", indicate the weed species, control area, control type, application rate and treatment date on the report map. <br />14. Is adequate topsoil reserved for reclamation, based on your approved permit? ES NO N/A <br />If "NO ", please explain: <br />15. Is the reserved topsoil vegetated/stabilized in accordance with Rule 3.1.9(1)? <br />If "NO" please explain: <br />16. If mining has exposed groundwater, is the site in compliance with the approved mining plan and Office of the Slate <br />Engineer (Well Permit, S.W.S.P., and/or Permanent Augmentation Plan)? YES NO (N /A <br />17. Are all hazardous materials stored within approved spill containment structures? <br />18. Is your financial warranty value sufficient to cover the cost to complete reclamation? <br />19. Is your basis for legal right to enter still valid? <br />20. Does your permit require you to submit monitoring information annually? <br />If "Yes ", please attach the required monitoring results to this Annual Report. <br />YES NO <br />YE NO N/A <br />NO <br />Page 3 of 3 <br />ES NO N/A <br />YES <br />(1G0 N/A <br />21. As required by rule, attach a map to this report that accurately depicts the permit boundary, current affected area <br />boundary and location of the acreages specified in items 7- 12 and 14. UPDATED MAP ATTACHED: N <br />p1 ) C hbt .{-f pre. ✓ r erK r <br />Division records indicate the following permittee contact information. If this in ormation is hot current, p ease 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 are <br />being conducted in accordance with the Division approved mining and reclamation plans. <br />Li-714i tjeda,Pr , , IAA dint PI 94 1 /(511' <br />Signat a of Permittee, Corpor Officer, Owner, br Documented Designee Date <br />