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<br />ANNUAL REPORT <br />PERMITTEE NAME: Weld County <br />PERMIT NO.: M-1978-210 <br />OPERATION NAME: Geisert Pit <br />ANNNERSARY DATE; March 1, 2000 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $550.00 <br />COUNTY: Weld <br />REC ~~~ ~~~~~~~~~~~~~~~~ <br />r~ Q C_ ",_~uU sss <br />piaswn of ~iine~~ & Geolo9Y <br />~ `. ~ ~ ~~~ <br />~~ <br />According to C.R.S. 34-32-116(3)(a), each yeaz, on the anniversary date of the permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding yeaz, new <br />disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this annual report. <br />Please note that an adey~uuely labeled map that clearly delir:eates and includes Jhe above <br />elements may suffice for a written reporl. <br />Please type or print the current contact person's name, mailing address, and phone number in [he <br />space provided: <br />Contact Name: ~ f_~ „~/~ISOn Company: 1r/~ ~a ('~~~~Du~/~~ Vn/o~a <br />Address: ~ _,[7D [n,~7 S fi' Phone No.: (970 ) 356-+1oao x~75v <br />~~~~v~y~0~3~ FAX No.: (97D )_" O~-6 ' 97-697 <br />If there are additional comments and/or information that should be provided to the Division, <br />please provide it on a separate sheet and attach it to this report form along with your map and/or <br />written report. <br />~~~/ ~J <br />~gnature f Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />M'~PERM fIN1 ASTERDOC U MENTSNi-AF-Ui <br />