2012-10-11_REPORT - M1982154

• Permit No: M1982154
• IBM Index Class Name: REPORT
• Doc Date: 10/11/2012
• From: Farnsworth Construction and Gravel Company
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

Permittee Contact:
Patricia Farnsworth
./
Permittee Company:
Farnsworth Construction and
Gravel Company
Address:
175 Hwy 133
Paonia, CO 81428
Phone Number:
(970) 527 -4434
Fax Number:
(970) 527 -5522
Email Address:
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13. Is weed control being conducted in accordance with an approved Weed Control Plan? YES NO N/A
If "YES ", indicate the weed species, control area, control type, application rate and treatment date on the repo ap.
14. Is adequate topsoil reserved for reclamation, based on your approved permit? YES 'NO N/A
If "NO ", please explain:
15. Is the reserved topsoil vegetated /stabilized in accordance with Rule 3.1.9(1)?
If "NO" please explain:
YES NO
16. If mining has exposed groundwater, is the site in compliance with the approved mining plan and Office of the State
17. Are all hazardous materials stored within approved spill containment structures?
18. Is your financial warranty value sufficient to cover the cost to complete reclamation?
19. Is your basis for legal right to enter still valid?
20. Does your permit require you to submit monitoring information annually?
If "Yes ", please attach the required monitoring results to this Annual Report.
Engineer (Well Permit, S.W.S.P., and /or Permanent Augmentation Plan)? NO N/A
Signature of Permittee, Corporate Officer, Owner, or Documented Designee
YES NO �A i
YES NO N/A
YES NO
YES NO ' N/A
21. As required by rule, attach a map to this report that accurately depicts the permit boundary, current affected ar9
boundary and location of the acreages specified in items 7- 12 and 14. UPDATED MAP ATTACHED: / C)
Division records indicate the following permittee contact informations. If this information is not current, please t pe, or
print current contact information: -77
I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are
being conducted in accordance with the Division approved mining and reclamation plans.
/G - `i — /2.
Date