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Permittee Contact: <br />Tim Huskey <br />Permittee Company: <br />Dolores County Road & Bridge <br />Dept. <br />Address: <br />1010 N. Guyrene <br />PO Box 608 <br />Dove Creek, CO 81324 <br />Phone Number: <br />(970) 677 -2328 <br />Fax Number: <br />(970) 677 -3759 <br />Email Address: <br />CF.PR.email <br />13. Is weed control being conducted in accordance with an approved Weed Control Plan? <br />If "YES ", indicate he weed species, coqntrol area, onttrol type, applic tion ate and treatment <br />Tcc•+�/o� � <br />- oven roe" c d IQpsa,1 - rlandSpr�y :h y - <br />14. Is adequate topsoil reserved for reclamation, based on your approved permit? <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 />- 14 -« <br />' gnature of Permittee, Co ry] F ate Officer, Owner, or Documented Designee <br />NO N/A <br />ate on the report map. <br />a /6ir9 - Y / /// <br />NO N/A <br />16. 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 />YES NO <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 />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: y e S <br />Division records indicate the following permittee contact information. If this information is not current, please type or <br />print current contact information: <br />YES <br />NO N/A <br />NO N/A <br />NO <br />NO N/A <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 />? <br />Date <br />Page 3 of 3 <br />