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<br />ANNUAL REPORT <br />PERMITTEE NAME: Western Mobile Southern, Inc. <br />PERMIT NO.: M-81-307 <br />OPERATION NAME: Fountain Pit <br />ANNNERSARY DATE: December 03, 1999 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $550.00 <br />COUNTY: EI Paso <br />~.+ EIVED <br />3 1 2000 <br />0[ws[on of Mmerab 6 Geohtgy <br />According to C.R.S. 34-32.5-116(3)(a), 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 <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coning <br />year, the dates for the beginning of active operations, and the date active operations ceased for the year, <br />if any. <br />Please attach your revised annual report map and written report to this annual report. Please <br />note thin an ndegaately labeled map that clearh~ delineates mtd includes the above elements mny <br />sn~ce for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: r-,c 7~( k~'~ "p Company: f ~~rf1 la <br />-~~ <br />Adddre~s-s-:~/Sfo y i1r~ ~~~ Phone No.: (~~~ ~5raz - y~aa <br />~Jv..vi f 6~2~y FaxNo.:(~u~ ~r~ - Y33g <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />i~~~a o <br />Signature of Co orate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />