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Permittee Contact: <br />Mark Dorenkamp <br />Permittee Company: <br />Prowers County <br />Address: <br />301 S. Main, Ste. 215 <br />Lamar, CO 81052 <br />Phone Number: <br />(719) 336 -5536 <br />Fax Number: <br />(719) 336 -2255 <br />Email Address: <br />CF.PR.email <br />13. Is weed control being conducted in accordance with an approved Weed Control Plan? /TO N° N/A <br />If "YES ", indic to the weed species, control area, cont. of type, application rate and treatmen{� e on the report map. <br />72 / 1 T`_ � /`` 11 ///A .5 <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 />YES NO alai <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 <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? YES NO <br />19. Is your basis for legal right to enter still valid? E,S' NO <br />20. Does your permit require you to submit monitoring information annually? YES NO <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 />YES NO (N /A <br />Signature of Permittee, Corpofate Officer, Owner, or Documented Designee Date <br />- 2/:7- <br />Page 3 3 <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 wi h the Divisio approv d ning and reclamation plans. <br />/ 1/1--; Jj�. / r J-r / <br />