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<br />PERMITTEE NAME: <br />PERMPI' NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~-~ 5 (~ P i <br />ANNUAL FEE and REPORT REQUEST <br />Natural Soda, Inc. <br />~M-1999-051 <br />Rock School Lease Experimental Nabcolite Mine <br />February 28, 2007 <br />$5550.00 (Doe on or before your anniversary date) <br />Rio Blanco <br />pi,,; .:a:e 26 ~r~~ <br />viinii ~ y w,u .- ' ~-:Jas. <br />~Urc,y <br />According m C.R.S. 3432.5-116 or C.R.S. 3432-116, each year, on the armivetsary dam of the permit, an <br />opetatot shall submit the annual fce, a report and map showing the extort of current disturbances to affected <br />land, reclamation accomplished m date and during the preceding year, new disturbances that are antlcipated m <br />occur during the upcoming year, reclamation that.will be perforrned.during the coming year, the dates for the <br />begimring of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and ammasl report map to this form. The Annual <br />Report 8r Fee requirement is not met untll we Lave received the following components: fee. renort. snd <br />assodated map. Ii no new disturbances or reclamatbn Lave oautrred dnrin¢ the orevtoua year and no <br />Ooeramr stall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the above elements may suffrce for a written rnport. <br />Division records irdicam the following permittee contact information. Please verify and make arty necessary <br />changes: <br />Permittee Contact: -~d-i~reer- <br />Pemtittce Name: <br />Address: <br />Phone Number. <br />Fax Number: <br />Natural Soda, Inc. <br />Rifle, CO 81650 <br />(970) 878-3674 <br />(970) 878-5866 <br />Cindi Burns <br />3200 Rio Blanco County Road 31 <br />If you have additional comments and/or information that should be provided to fire Division, please provide it <br />below or attach it m this form along with yore written report and map. Annual Report instructions are <br />enclosed <br />G ~ ~ [~~, 1`r-`7 <br />Signature of Corporate car, Owner, ar Designee <br />February 15,2007 <br />Date <br />~:~. <br />~. <br />-~~~~ <br />~-F~ ?~ <br />M. -MVLmOC <br />