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~ IIIIIIIIIIIIIIIIIII <br />999 <br />ANNUAL REPORT <br />PERMITTEE NAME: Williams Fork Mining Company <br />PERMIT NO.: M-84-168 <br />OPERATION NAME: Williams Fork Pit <br />ANNNERSARY DATE: October 25, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Moffat <br /> <br />RE~E~~ED <br />O~hsion or Mine~~ 8 ~eologY <br />iii ~,, <br />~~~ ~ ~~ <br />According to C.R.S. 34-32-1 16(3)(x), each year, 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 year, 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 <br />annual report. Please Wore that nn ndequateh~ labeler( neap shat clearly de/ineater and <br />includes the above elenrenrs may suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name: Forrest Luke Company: Williams Fork Mining Company <br />Address: P o <br />Craig CO 81626 <br />Phone No.: ( 970 ) 824-4401 <br />Fax No.: ( 970 ) 824-4632 <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 />Signature of Corporate Officer, or Owner <br />10/20/99 <br />Date <br />INSTRUCTIONS ON BACK <br /> <br />