Cal. Code Regs. Tit. 14, div. 2, ch. 8, subch. 1, art. 8, form MRRC-4M
State of California
DEPARTMENT OF CONSERVATION
Request for Multiple-Site Method of Fee Assessment
MRRC-4M (Revised 04/97)
Requested by: __________
Mine Operator or Mining CompanyMULTIPLE-SITE SINGLE FEE REQUEST FOR 1996 REPORTING PERIOD
Operators with multiple, ACTIVE surface mining operations may qualify for a reduced, single reporting fee of $2,000, if answers to ALL of the following questions are "YES" (idle mining operations must be reported separately):
| Yes [] | No [] | 1. | Are all of the operations operated by a single operator or mining company? | |
| Yes [] | No [] | 2. | Is the total combined production of the primary commodity for all operations: | |
| a) less than 100 troy ounces for precious metals? | ||||
| OR | ||||
| b) less than 100,000 short tons for non-precious metals? | ||||
| Yes [] | No [] | 3. | Are all operations active? | |
| Yes [] | No [] | 4. | Are idle operations excluded from this request? | |
| Yes [] | No [] | 5. | Will all active operations within the State operated by this operator or company be listed on this single fee request form? | |
| Yes [] | No [] | 6. | Will this completed form be submitted with separate annual reports for each operation? (California Code of Regulations [CCR] requires the $2,000 single fee to be paid by July 1, 1997.) | |
IF YOU ANSWERED "NO" TO ANY OF THE QUESTIONS ABOVE (ITEMS 1-6), THE OPERATIONS DO NOT MEET THE MULTIPLE-SITE SINGLE FEE REQUIREMENTS OF CCR SECTION 3697. IF YOU ANSWERED "YES" TO ALL OF THE QUESTIONS ABOVE, COMPLETE THIS FORM AND SUBMIT IT TO THE OFFICE OF MINE RECLAMATION WITH THE SEPARATE 1996 MINING OPERATION ANNUAL REPORTS FOR EACH OPERATION LISTED BELOW (for additional sites, please attach a separate sheet):
| CA MINE ID# | PRIMARY COMMODITY | AMOUNT PRODUCED | CHECK ONE | |
| Short Tons | Troy Ounces | |||
| TOTAL COMBINED AMOUNT PRODUCED | ||||
If the Department of Conservation determines that the multiple-site single fee is not warranted, the operator shall remit annual reporting fees calculated upon the total primary mineral commodity produced on each of the site listed above, pursuant to CCR Section 3698. Such fees shall be remitted within thirty (30) days of notification by the Department of Conservation. An operator or owner remitting an annual reporting fee later than thirty (30) days after notification, shall be assessed penalties and interest, as provided for in Public Resources Code (PRC) Section 2207(d)(5).
I certify that the information submitted herein is complete and accurate (failure to submit complete and accurate requisite information may result in the imposition of an administrative penalty of up to $5,000 a day, as provided for in PRC Section 2774.1).
| ___________________________ | ___________________________ | ___________________________ | ||
| Signature | Title | Date |
Cal. Code Regs. Tit. 14, div. 2, ch. 8, subch. 1, art. 8, form MRRC-4M