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Permittee Contact: <br />Permittee Company: <br />Address: <br />Phone Number: <br />1-ax Number: <br />Email Address: <br />UPDATED MAP ATTACHED: CONDITIONS UNCHANGED - PREVIOUS MAP ACCURATE: <br />14. Is weed control being conducted in accordance with an approved Weed Control Plan? YES NO N/A <br />If "YES ", indicate the weed species, control area, control type, application rate and treatment date on the report map. <br />15. Is adequate topsoil reserved for reclamation, based on your approved permit? <br />If "NO ", please explain: <br />16. Is the reserved topsoil vegetated /stabilized in accordance with Rule 3.1.9(1)? <br />If "NO" please explain: <br />Signature of Cor orate Officer, I caner, or Documented Designee <br />NO N/A <br />NO N/A <br />17. If mining has exposed groundwater, is the site in compliance with the approved mining plan and Office of the <br />f +e <br />Engineer (Well Permit, S.W.S.P., and /or Permanent Augmentation Plan)? YES NO EAII <br />8. Are all hazardous materials stored within approved spill containment structures? YES NO <br />19. Is your financial warranty value sufficient to cover the cost to complete reclamation? NO N/A <br />20. Is your basis for legal right to enter still valid? NO <br />21. Does your permit require you to submit monitoring information annually? YES e N/A <br />If "Yes ", please attach the required monitoring results to this annual report. <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 <br />are being conducted in accordance with the Division approved mining and reclamation plans. <br />