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Permittee Contact: <br />Orvie Zimmerman <br />Permittee Company: <br />Blue Jet Mining Inc <br />— _ <br />Address: <br />. <br />P.O. Box 181 <br />Craig, CO 81626 <br />C uR 4L - /v l <br />Phone Number: <br />(970) 824 -5049 <br />_ <br />Fax Number: <br />x <br />FA X <br />Email Address: <br />CF.PR.email <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 />19. Is your basis for legal right to enter still valid? <br />Signature of Pe Corporate Officer, Owner, or Documented Designee <br />Dat <br />Page 3 of 3 <br />13. Is weed control being conducted in accordance with an approved Weed Control Plan? NO N/A <br />If "YES ", indicate the weed species, control area, control type, application rate and treatment date on the report map. <br />NO N/A <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)? NO N/A <br />17. Are all hazardous materials stored within approved spill containment structures? NO N/A <br />/v ° N A Z A R 4 i, co S iv% A 7 C AI A G. Co ti/ $ i T L: <br />18 Is your financiaLwarranty valve sufficient to cover_the r, ost_to_completesec1amatinn9 �y __O N/A _ ^_ <br />�7 NO <br />20. Does your permit require you to submit monitoring information annually? YES NO N/A <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 />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 />