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Permittee Contact: P <br />Phil Dorenkamp <br />Permittee Company: L <br />Las Animas County <br />Address: 2 <br />2000 N. Linden <br />Trinidad, CO 81082 <br />Phone Number: ( <br />(719) 846 -2931 <br />Fax Number: <br />Email Address: C <br />CF.PR.email / <br />/as d 4 i rvi (if cc -a Aril A C ✓Ltd / 4 co'm <br />C1) <br />If "YES ", indicate the weed species, control area, control type, application rate and treatment date on the rep. <br />rL/ fV l / � � ?e D 7c C�v > ' /� ✓ jtV /1z <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 />16. If mining has exposed groundwater, is the site in compliance with the approved mining plan and Office of the <br />Engineer (Well Permit, S.W.S.P., and/or Permanent Augmentation Plan)? <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? YES <br />(YES NO <br />20. Does your permit require you to submit monitoring information annually? YES <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: <br />Division records indicate the following permittee contact information. If this information is not current, please type or <br />print current contact information: <br />19. Is your basis for legal right to enter still valid? <br />being condo /d in accordance with the Division approved mining and reclamation plans. <br />I9 <br />Sign.' ure • ' ermittee, Corporate Officer, Owner, or Documented Designee <br />C YES NO N/A <br />YES NO N/A <br />YES NO <br />YES NO <br />NO <br />Page 3 of 3 <br />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 />3- QI - )Q- <br />Date <br />