2023_Annual Reclamation Report_59-28

Action History(UTC-05:00)
Submit by Anonymous User 9/6/2024 9:39:38 AM(Start)
Approve by Kelly Jonas 9/6/2024 1:13:43 PM (ARR Review-59-28 Roberson Sand Pit)
• The task was assigned to DEMLR Mining ARR Team.The due date is:September 20,2024 5:00 PM
9/6/2024 9:40:07 AM
• Kelly Jonas assigned the task to Kelly Jonas 9/6/2024 1:11:20 PM

2023 Annual Reclamation Report
Complete and submit by September 1,2024 in
N.C. Department of Environmental Quality-Division of Energy,Mineral,and Land Resources
GENERAL INFORMATION
Mining Permit No.(?)
59-28
Once the permit number is entered,click outside the field box to prompt more information to pre-populate
Release Date(If Applicable) Original Issued Date Mine Data Current as of:
02/23/2018 07/30/2024
Legal Corporate/Owner Name*
Roberson Sand Pit II LLC
Mine Name*
Roberson Sand Pit
Mine Address(You Must Enter)*
(The 911 Address)
Street Address
1901 Eli Bowen Rd
Address Line 2
City State/Province/Region
Williamston North Carolina
Postal/Zip Code
27909
County* River Basin*
Martin Roanoke
Dropdown list Dropdown list
County Prefix Code*
59
Variable available for repository routing
Facility Coordinates:
Latitude:* Longitude:
35.78790 -77.08630
Responsible Official/Authorized Contact Information:
Name and Title*
Roberson Sand Pit 11 LLC

Mailing Address*
1824 Holly Spring Church RoadWilliamston,NC 27892
Primary Phone No.* Secondary Phone No.
2527997076
E-mail Address*
[e-mail]
Invoice Contact Information:
(Contact info from above is carried below-please revise if needed)
Name and Title*
Roberson Sand Pit II LLC
Mailing Address*
1824 Holly Spring Church RoadWilliamston,NC 27892
Primary Phone No.* Secondary Phone No.
2527997076
E-mail Address*
[e-mail]
Is the site Active?*
Yes No
Was new land affected in 2023?* If yes, how much?(Acres)*
Yes No 0.5
Is the map on file current?*
Yes No
Check here if no reclamation was completed in 2023
State and describe the amount and type of reclamation carried out in 2023 calendar year:
Pit is currently being mined out.
List by category the total amount of disturbed and unreclaimed land present at this site at the end of the 2023 calendar year:
Tailings Ponds* Stock Piles* Waste Piles*
0.0 0.0 0.0
Acres Acres Acres(WASTE PILES should include
overburden storage/disposal areas and
berms)
Plant Area* Mine Excavation* TOTAL DISTURBED AREA*
0.0 0.5 0.5
Acres Acres Acres(Calculated Sum)

Is there any other supplemental information you want to upload to submit with this report?
Must be.pdf format(Max size 100 MB each)
(If applicable)Please explain additional attachments that were uploaded:
NEW DISTURBANCE ESTIMATES FOR 2024
Check here if no new acreage to be affected in 2024
Certification and Signature*
By checking the box and signing box below, I certify that:
• I have given true,accurate,and complete information on this Annual Reclamation Report form and in the uploaded map document(s);
• I agree that submission of this Annual Reclamation Report Upload form is a"transaction"subject to Chapter 66,Article 40 of the NC
General Statutes(the"Uniform Electronic Transactions Act');
• 1 agree to conduct this transaction by electronic means pursuant to Chapter 66,Article 40 of the NC General Statutes(the"Uniform
Electronic Transactions Act');
• I understand that an electronic signature on this form has the same legal effect and can be enforced in the same way as a written
signature;
• I intend to electronically sign and submit this Annual Reclamation Report form;AND
• I have the authority to submit this Annual Reclamation Report on behalf of this Mining Permittee.
Signature of Responsible Official/Authorized Contact:* Date*
09/06/2024
ah tew, .5'a&t'jay
Type Name* Title*
Brent Roberson Mine Manager
Email Confirmation will be sent to:*
[e-mail],[e-mail]
Additional E-mail Contact for Confirmation(if desired)
[e-mail]
This submission is associated with Business Process Instance ID 216663.