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- iii iiiiiii~niu ui <br />. Annual Reclamation _ _ 99r _ _ t ,~~ _ <br />cE~v~e <br />/A <br />This form may be used by coal mines that have not distk~~~ed acreag9~ <br />or conducted reclamation activities during the past calendar ~~aisR~~r <br />2.04.13 requires that coal mines file an annual reclamation report°9Y <br />covering the previous calendar year, for all areas under bond. An <br />Annual Reclamation Report is due on the 15th of February of each <br />year unless another date is specified in the permit. <br />To use this form, your mine must meet the following criteria: <br />a) has not disturbed additional acreage during the past calendar year. <br />b) has not backfilled and graded during the past calendar year. <br />c) has not topsoiled during the past calendar year. <br />d) has not seeded, planted or augmented seeding or cultural practices during the past <br />calendar year. <br />If you meet the above criteria then the following information will be adequate for the <br />Annual Reclamation Report: <br />PermitteeName: NATroNn~ /!lots cogs rNC. PermitNo.: C- 8/- 03 S <br />Stmet Address: vy2 5' c2 /2 0 <br />City: NESPE.2us ,Colorado Zip Code: 8/ 3 2 6 <br />This report covers calendar year 199 N <br />Please Note: <br />If this mine has reclaimed acreage in the past, please attach to this form, a list of the <br />locations, number of acres and date of planting for all previously revegetated areas. The <br />permittee may provide additional monitoring information as required by the approved <br />permit <br />SignatureotPermittee: ~1.~ ~~d~^%~ Date: ~ 95 <br />RPP/rpp/arpform.wp 2/t 1/92 <br />