This government document is issued by Department of Environmental Quality for use in Montana
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https://www.google.com/url?client=internal-element-cse&cx=013380590290877010950:k96xc8aze6c&q=https://deq.mt.gov/files/Land/Hardrock/Forms/OP/AnnualRenewalForm/Annual%2520Renewal%2520Form.pdf&sa=U&ved=2ahUKEwi91PeS0PGHAxUY_7sIHSpoLAY4PBAWegQIABAB&usg=AOvVaw1aoaxu1sD7ptGeEVLKnSRE&arm=e