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Permittee Contact: <br />RalpirMartirfez <br />Nev rA4 „Fri--(t. \,k) <br />Permittee Company: <br />Southway Construction <br />Company, Inc. <br />Address: <br />117 White Pine Dr <br />Alamosa, CO 81101 <br />Phone Number: <br />(719) 589 -5103 <br />Fax Number: <br />(719) 589 -5522 <br />Email Address: <br />7 7 ' _C 1 4 11 1 1 4-'et y l? C. ) . <br />C c - Y - Y Y 1 _ <br />13. Is weed control being conducted in accordance with an approved Weed Control Plan? YES (NQ 1 N/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? <br />If "NO ", please explain: <br />Sig ure o unit orporate Officer, Owner, or <br />Page 3 of 3 <br />YES NO (N /A,. <br />15. Is the reserved topsoil vegetated /stabilized in accordance with Rule 3.1.9(1)? YES NO CN/A/ <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 State <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? YES NO CN /k- <br />18. Is your financial warranty value sufficient to cover the cost to complete reclamation? (S NO N/A <br />19. Is your basis for legal right to enter still valid? 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: e— <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 />"12 <br />Date <br />