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Annual Reclamation Report IIIIIIIIIIIIIIIIIII <br />This form may be used by coal mines that have not disturbed acreage <br />or conducted reclamation activities during the past calendar year .Rule <br />2.04.13 requires that coal mines file an annual reclamation report <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: A/Ario,ys~ /!iAl6 coALermitNo.: C- Sl 035 <br />Street Address: ~/~,' 2 y G .Q /2 0 <br />City: h/ E s yC,e u s ,Colorado Zip Code: ~/ 3 Z 6 <br />This report covers calendar year. 199,E <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 />Signature <br />RPP/rpp/arpiorm.wp 2/11/92 <br />Date: i 9Y <br />~;-~ ., , <br />JP.PI C 7 1S9/~ <br />