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Permittee Contact: <br />Shane Cooper <br />Permittee Company: <br />Shane Cooper <br />Dirt ga L <br />Address: <br />949 Shannon Rd. <br />Cotopaxi, CO 81223 <br />Aft. t AwYS 2.4 G <br />Phone Number: <br />(719) 276 -3234 <br />(d` I1) 719- 39/ °l937 <br />Fax Number: <br />(719) 276 -3234 <br />Email .A.ddress: <br />CF.PR.email <br />Gjr r . —���1 1 X1 A o o. e. a rh <br />13. Is weed control being conducted in accordance with an approved Weed Control Plan? YES NO <br />If "YES ", indicate the weed species, control area control type, application rate and treatment date �rn the repo map. <br />14. Is adequate topsoil reserved for reclamation, based on your approved permit? ) 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 />ure of Permittee, Corporate Officer, Owner or Documented Designee <br />16. If mining has exposed groundwater, is the site in compliance with the approved mining plan and Office of the State <br />il <br />Engineer (Well Permit, S.W.S.P., and/or Permanent Augmentation Plan)70 a td4f YES NO <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? <br />19. Is your basis for legal right to enter still valid? <br />20. Does your permit require you to submit monitoring information annually? <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 ATTACIfIED: <br />�l D c.Actii5 t" /MO <br />Division records indicate the following permittee contact information. If this information is not current, please type or <br />print current contact information: <br />YES') NO <br />�.a <br />YO NO <br />YES) NO <br />YES, <br />.. <br />Date <br />Page 3 of 3 <br />N/A <br />N/A <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 />being conducted in accordance with the Division approved mining and reclamation plans. <br />