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Permittee Contact: <br />Lee Roy Rothe <br />Permittee Company: <br />Lee Roy and Marlene J Rothe <br />Address: <br />19727 Factory St <br />Sterling, CO 80751 <br />Phone Number: <br />(970) 522 -2281 <br />Fax Number: <br />(970) 522 -2282 <br />Email Address: <br />r C A O'er ` 1 KC I . k <br />Page 3 of 3 <br />13. Is weed control being conducted in accordance with an approved Weed Control Plan? S_i NO 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? YES NO N/A <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 />YES 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 (N /A <br />17. Are all hazardous materials stored within approved spill containment structures? YES NO N/A <br />18. Is your financial warranty value sufficient to cover the cost to complete reclamation? . YES 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 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 />� � \\_2.0 Z- <br />c -\ <br />Signature of Permit Cor orate Officer, Owner, or Documented Designee Date <br />