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~~~ ~~~~~~~~~~~~~ ~~~ ~4F c~, , Notice of Intent to Continue ~,~...,ig Operatio~ ~ ~ . '9/li ~ ~ 110(2) Annual Report ~s/o 1 ~J ~% ~ 99s Permittee Name: David Goss P~d/ s Permit No: M-85-140 CC Operation Name: Goss Sand & Gravel* P~/o9 Anniversary Date: 01/24/95 y Total: $225.00 (Due on your Anniversary Da te) 1. a. Permitted acreage: °~i ~' _ b. County where mine is lo .,p cated: L f ~-° ~ 2. Has this min e been granted TEMPORARY CESSATION STATUS? YES NO Does this mi ne operate MORE or LESS than 180 days per year? MORE LESS T Do you extra ct MORE or LESS than 70,000 tons of mineral or overburden a year? MORE LESS 3. Does this mi ne have a phased reclamation plan? YES NO 4. Total acres affected during--the report year:* _ - ~Y^~---` , 5. Total acres reclaimed for the report year:* `Yu'``~' 6. Total acres in various stages of reclamation:` a. Backfille d: ~~e-wc_ d. Topsoil replaced : b. Graded: ~jJ'Lo-i.~ Average topsoil thickness c. Seeded: ~~"'«Q~ replaced: ~7v+ -LQ__ List spec ies seeded & seeding rate for report year on back 7 8 9 * Please show the location of the acreage for items 4 - 6 on your map**. Indicate the phases of the reclamation which have been completed, correlated with your Ttimetable. - ** NOTE: If there have not been any changes since the last annual report and you previously submitted a map which correctly depicts the current acreage in items 2 through 6, then a ne map is unnece ry. However, this must be stated above. .~ Signature: , ~ Date: ~ Please type or print curre - contact name, mailing address, and phone number below: , Contact Name: fl ~V t >> CYa s_s ~ Phone: ('7 1 ~) ~e ~'~ .... ~L~./<,~ Company: (~D 5S ~~~,D ~ (-'~rrr„r~ Address: Ca7Sq .i= / l~ c~7Y' /~+~~u Cpl j~~i, G'~ ~o ~~. 9'N ~9 ~~ Federal Tax ID No. or Social Security No.: The type and approximate quantity of .fertilizers, organic material or soil conditioners used for the report year:* ~-yc_~ Estimated total acres to be affected in the next report year:*