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ANNUAL FEE and REPORT RE VEST <br />PERMITTEE NAME: Sandco Inc - V29 <br />PERMIT NO.: ?M-1987-064 AUG 0 2 m o <br />OPERATION NAME: Dalton Land & Cattle Dh*ien of Kc0Qrnj tfon, <br />ANNIVERSARY DATE: August 27, 2010 Aflnl?og and Safety <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: La Plata <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, 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 land, <br />reclamation accomp fished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual report may to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's may are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: David Dillon <br />Permittee Name: Sandco Inc <br />Address: P.O. Box 4440 <br />Durango, CO 81302 <br />?!/Yl/?Yl t'i <br />14o ,Ww <br />• <br />Phone Number: (970) 247-1303 <br />Fax Number: (970) 382-9220 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />ignature of Corporate Officer, Owner, or Designee <br />Date