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Permittee Name: <br />Operation Name. <br />Annual Fee Due <br />Permit Acreage• <br />110c Annual Report ) <br />According to C.R S 34- 32.5 -1 16 or 34 -32 -1 16. each \ear. on the anni\etsar\ date of the permit. an operator shall submit <br />the Annual Fee. an Annual Report and map showing the e\tent of cun disturbanc to affected land. required <br />monitoring information, reclamation accomplished to date and during the preceding \ eai an\ new disturbance that is <br />anticipated to occur during the upcoming ■ear. an■ reclamation that \\ ill he performed during the upcoming year the <br />dates for the beginning of acti\ e operations. and the date acme opelation ..ased f i the s ear <br />Information contained in this report will be re\iewed h\ tFe Di\ision upon receipt and prior to the net compliance <br />inspection of the site. If. while completing this report. \ou learn that \ our site is not in compliance w ith the rules and the <br />act, it is advisable that the issues be rectified promptl■ to w ord possible enforcement action <br />Sedgwick Count\ <br />Kmnie Gra\el Pit Count\ Sedg \\ ick <br />8323 00 Ann! \er Date September 5. 2012 <br />9 90 <br />1. Is the site identification sign posted in accordance w ith Rule 3 1 12i 1 <br />' Permit Number NI -1997 -061 <br />Current Bond . SO 00 <br />2 Is the affected area houndar\ c learl marked in aLcorcance \\ ith Rule 3 1 ' i <br />3. Is the mine site in final reclamation (all material c \traction and stockpile remo\al is completes' <br />If "YES." please note time limits related to completion of reclamation. Rule 3 1 3 <br />What was the date of last etca\ation. processing or hauling acti\it\ at the mine' <br />5. Does the mine operate more than 180 da\ s per \ ear <br />If "NO please re\ iew Rule 1 13 to assure that \ our rime is in compliance <br />OCT 10 2012 <br />ONI810N <br />6. Has this mine been granted. a) approN. al of TE.\IPORARY CESS.-\TIO\ gAN <br />b) appro\al for I_NTERsIITTENT OPERATION' <br />7. Number of acres currently affected ( mining + Incomp ete and or unreleased reclamation i <br />8. Number of acres that were new l\ affected during the current report \ ear <br />9. Number of acres that \\ ere reclaimed durin the ,:Uric' it reperr <br />10. Estimated new acreage to be affected in the net report \ear <br />11. Estimated acres to he reclaimed in the nest report �etn <br />12. Total acres in \ arious stages of reclamation. since permitted mining acti\ities began <br />Total acres ; Total acres j Total acres , Total acres <br />backfilled. seeded wi wr'topsoii mulched w/ <br />appro\ed min . replaced appro\ed mulch <br />Total acres Total acres Topsoil Mulch application <br />graded. ' fertilized w/ replacement rate l tons <br />ap\d fertilizer I depth tin i. <br />Seed I Fertilizer `Iu1ch <br />application j application application <br />method: method method <br />YES <br />YES <br />Page 2 t 3 <br />) <br />