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,. r y�� . III I II I II I II IIII III • <br /> 999 <br /> ANNUAL FEE and REPORT REQUEST <br /> PERMITTEE NAME: Ace West Trucking, Inc. RECEIVED <br /> PERMIT NO.: M-1987.103 AUG 2 3 2001 <br /> OPERATION NAME: East Douglas Pit <br /> ANNIVERSARY DATE: August 24,2001 Division of Minerals and Geology <br /> ANNUAL FEE DUE: $281.00(Due on or before your anniversary date) <br /> COUNTY: Rio Blanco <br /> According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year.on the anniversary date of the permit, an operator <br /> shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br /> reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br /> during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br /> of active operations, and the date active operations ceased for the year, if any. <br /> Please attach your revised written annual report and annual report map to this form. Please note that an <br /> adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact Donald O. Rooks,Jr. <br /> Permittee Name: Ace West Trucking, Inc. <br /> Address: P.O. Box 250 <br /> Rangely, CO 81648 <br /> Phone Number: (970) 675-2753 _ <br /> Fax Number: (970) 675-2702 <br /> If you have additional comments and/or information that should be provided to the Division, please provide it <br /> below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br /> �c�.t,3t9 c7 . <br /> Signature of Corporate Officer or Own r <br /> f :vet <br /> Date <br /> M TERMITWASTERDOCUMENTSW AF 01 <br />