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J\P 4, RPT <br />ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: Ace West Trucking, Inc. <br />PERMIT NO.: M-1987-103 <br />OPERATION NAME: East Douglas Pit <br />ANNIVERSARY DATE: August 24, 2010 <br />ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date) <br />COUNTY: Rio Blanco <br />RECEIVED <br />,/ AVG 2 6 2010 <br /> <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 />-_..___shaU-submit-_the_annual_fee,_a_report.and_map_showing-,.the._ extent_ of-current_.disturbances_ to_ affected land,- <br />reclamation accomplished 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 your revised written annual report and annual report map 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 chances to <br />the previous vear's map are necessarv, then no new map is reauired. 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 suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Donald O. Rooks, Jr. <br />Permittee Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />Ace West Trucking, Ina <br />15672 Hwy. 64 <br />P.O. Box 250 <br />Rangely, CO 81648 <br />(970) 675-2753 <br />(970) 675-2702 <br />9o 2 (:?oni,o/'de ?- , <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 />Signa a of C orate Officer, Owner, or Designee <br />7 v <br />Date