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                                                                                                                           MARK CHURCH
EF-560-A-R05-0806-41000406-1                                                                                               Assessor - County Clerk - Recorder
BOE-560-A (S1F)  REV. 5 (8-06) 20 ___ AGGREGATE PRODUCTION REPORT (INCLUDES SAND,                                          555 County Center
                               GRAVEL, STONE, LIMESTONE, CLAY AND SIMILAR PRODUCTS                                         Redwood City, CA 94063
OFFICIAL REQUIREMENT                                                                                                       P 650.363.4500    F 650.599.7435
A report submitted  on this form is required of you by section  441(a) of the Revenue and Taxation       Code (Code).      email assessor@smcacre.org
The statement must  be completed according  to the instructions and filed with  the  Assessor on or before April           web www.smcacre.org
1, 20____ . Failure to file it on time will compel the Assessor’s Office to estimate the value of your property 
from other information in its possession and add a penalty of 10 percent as required by Code section 463.
This statement is not a public document. The information contained herein will be held secret by the 
Assessor (Code section 451); it can be disclosed only to the district attorney, grand jury, and other 
agencies specified in Code section 408.  Attached schedules are considered to be part of the statement.
Carefully read and follow the accompanying instructions.                                                                   2. LOCATION OF THE PROPERTY:
1. NAME AND MAILING ADDRESS:        (Make necessary corrections to printed name and mailing address.)                      Mine or quarry name 
                                                                                                                           Sec.               Twp.          Range 
                                                                                                                           3.  PARCEL NUMBER 
                                                                                                                           Tax rate area 
                                                                                                                           Legal description of property 
                                                                                                                           4.  PHONE NUMBER OF PERSON COMPLETING FORM
                                                                                                                            ( )
  5a. STATEMENT OF LAST CALENDAR YEAR’S OPERATION                             F.O.B. PRICE ON JANUARY         ROYALTY PAID 
                                                                              1 OF THIS YEAR PER UNIT            PER        14. NAME OF ALL MINERAL PRODUCTS MINED AND SOLD LAST YEAR
                                                                                                                 UNIT      (other than those listed in 5a, such as gold):
                                    UNITS         CU. YDS.        TONS
           MATERIAL                   PRODUCED                  SOLD
  FINE SAND                                                                   $                               $
  COARSE SAND                                                                                                               15.  ARE YOU THE  OWNER        LESSEE OR
  GRAVEL                                                                                                                      LESSOR OF THIS PROPERTY?
  ROCK
                                                                                                                           16. IF THE PROPERTY IS UNDER LEASE, WHAT IS THE DATE
  CRUSHED ROCK                                                                                                             OF THE LAST LEASE AGREEMENT? 
  LIMESTONE
  CLAY                                                                                                                     HAS THE LEASE BEEN AMENDED SINCE THIS DATE? 
  STONE                                                                                                                        Yes        No
  OTHER (specify)                 xxxxxx                   xxxxxx               xxxxxxxx                         xxxx
                                                                                                                            IS THERE MORE THAN ONE ACTIVE LEASE AGREEMENT?
                                                                                                                               Yes        No
                                                                                                                            IS THIS PROPERTY IN WHOLE OR IN PART A GOVERN MENT LEASE? 
                                                                                                                               Yes        No
  5b. STATEMENT OF LAST CALENDAR YEAR’S OPERATING COSTS*                                                                   17. IF THE PROPERTY IS UNDER LEASE, WHAT IS THE DATE
  MINING AND HAULING                                                                      $                                OF THE LAST ROYALTY AGREEMENT? 
  PROCESSING AND/OR MILLING                                                                                                HAS THE ROYALTY AGREEMENT BEEN AMENDED SINCE THIS DATE? 
  REPAIRS AND MAINTENANCE                                                                                                      Yes        No
  INSURANCE                                                                                                                 TOTAL ROYALTY PAID LAST YEAR:
  OVERHEAD
                                                                                                                            $ 
  UTILITIES
  SUPPLIES AND MATERIALS                                                                                                   18. TOTAL RENTAL PAID LAST YEAR:
  OTHER (itemize)                                                                                                          $
                                                                                                                           Note:  If the lease or royalty agreement has been renegotiated since 
                                                                                                                           JANUARY 1 last year, attach a copy to this report.
                                                                                TOTAL     $
  Do not include depletion, depreciation, amortization, interest on loans, income, franchise and property                  19.  USE-RESTRICTIONS AFFECTING VALUE 
*taxes, state and federal income taxes, royalty payments, or costs incurred after aggregate plant operations.
  6. RESERVES ON DECEMBER 31 OF LAST YEAR                                                                                   USE PERMIT NUMBER
     IN      TONS             CU.YDS.                                                                                       DATE 
  7. YEAR OF DEPLETION OF RESERVES
                                                                                                                           20. HAS AN ENVIRONMENTAL IMPACT REPORT BEEN FILED ON THIS
  8. SURFACE ACREAGE BEING MINED
                                                                                                                           PROPERTY?          Yes   No
  9. CONTEMPLATED ULTIMATE MINING DEPTH BENEATH SURFACE
10. DEPTH TO GROUNDWATER FROM ORIGINAL OR NATURAL                                                                          21.   REMARKS:
     SURFACE LEVEL
11.  ESTIMATED DATE FOR BEGINNING MINING OPERATIONS ON PROPERTY OWNED BY 
     YOU OR UNDER LEASE BUT NOT NOW BEING MINED
12. CURRENT DESIGN CAPACITY OF PLANT:                                     TONS/HOUR
                                                                OR CU. YDS./HOUR
13. STATE ALL ADDITIONAL INCOME OTHER THAN ABOVE DERIVED FROM THIS 
     PROPERTY SUCH AS GOLD EXTRACTION, ASPHALT PLANT SITES, READY                         $
     MIX PLANT SITES, OPEN STORAGE, ETC. 
                                                                                      (continued on reverse)
                                                                                THIS REPORT SUBJECT TO AUDIT. 



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EF-560-A-R05-0806-41000406-2
BOE-560-A (S1B) REV. 5 (8-06)

                                                                            DECLARATION BY ASSESSEE

                 Note: The following declaration must be completed and signed. If you do not do so, it may result in penalties.
I declare under penalty of perjury under the laws of the State of California that I have examined this production report, including accompanying schedules, 
statements or other attachments, and to the best of my knowledge and belief it is true, correct, and complete and includes all production and all property 
required to be reported which is owned, claimed, possessed, controlled, or managed by the person named as the assessee in this statement at 12:01 a.m. 
on January 1, 20             . 

                             SIGNATURE OF ASSESSEE OR AUTHORIZED AGENT*                                DATE
OWNERSHIP 
      TYPE  (3)              
                             NAME OF ASSESSEE OR AUTHORIZED AGENT* (typed or printed)                  TITLE
Proprietorship 
Partnership                  NAME OF LEGAL ENTITY (other than DBA) (typed or printed)                  FEDERAL EMPLOYER ID NUMBER
Corporation 
                             PREPARER’S NAME AND ADDRESS (typed or printed)           TELEPHONE NUMBER TITLE
Other 
                                                                                      ( )

*Agent: see page S2B for Declaration by Assessee instructions.



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EF-560-A-R05-0806-41000406-3
BOE-560-A (S2F) REV. 5 (8-06)

                                  INSTRUCTIONS FOR COMPLETING AGGREGATE PRODUCTION REPORT

Report on a calendar-year basis. If this report is prepared prior to January 1, any change in real property between the date the report 
is prepared and January 1 must be reported to the Assessor on a supplemental report.
All personal property, excluding stockpiles, owned by the respondent and any property belonging to others at this location as of 
January 1 must be reported to the Assessor on a Business Property Statement form.
A separate production report must be filed for each location and/or operation. A single report may cover several leases or parcels if 
all have the same geological characteristics and are operated as a unit. If lease, rent or royalty terms are not the same for all parcels, 
the parcels must be reported individually.
Maps or aerial photos should be submitted for every year in which changes have occurred in the development of the property. Use 
a map to describe and locate the property clearly. Include a plot plan that shows pit site, railroad spur lines, plant site, location of 
reserves, etc.
Line numbers listed in these instructions refer to identical line numbers printed on the form. At top of form fill in the year of the lien 
date for which this production report is made.

LINE 1.  NAME AND MAILING ADDRESS
         a.                       NAME OF OPERATOR (person or corporation)
                                  If the name is preprinted, check the spelling and correct any error. In the case of an individual, enter the last name
                                  first, then the first name and middle initial. Partnerships must enter at least two names, showing the last name, first
                                  name and middle initial for each partner. Corporation names should be complete so they will not be confused with
                                  fictitious or DBA (Doing Business As) names.
                               b. DBA OR FICTITIOUS NAME
                                  Enter the DBA name under which you are operating in this county below the name of the sole owner, partnership, or 
                                  corporation.
         c.                       MAILING ADDRESS
                                  Enter the mailing address of the legal entity shown in line 1b above. This may be either a street address or a post office 
                                  box number. It may differ from the actual location of the property. Include the city, state, and zip code.

LINE 2.  LOCATION OF THE PROPERTY
         Fill in the mine or quarry name and the section, township and range in which the mine or quarry is located.

LINE 3.  PARCEL NUMBER
         List the parcel number and tax rate area number, if known. Give legal description only if parcel number is not used. Also, 
         give legal description for any year in which there has been a change in lease boundaries.

LINE 4.  PHONE NUMBER
         Enter the phone number where we may contact you or your authorized representative for information regarding the subject 
         property.
LINE 5a. STATEMENT OF LAST CALENDAR YEAR’S OPERATION
         a.                       Complete the year for last calendar year’s operation.
                               b. Check one of the boxes for the production units used.
         c.                       Show the quantity produced and sold by category. If you produced aggregates other than those itemized, list them
                                  under “other.”
         d.                       Show the F.O.B. price per unit on lien date (January 1 of current year). Units used for the price should be the same as 
                                  production units used.
                               e. Show the royalty paid per unit if you lease the property. If the royalty is paid on total material removed rather than by 
                                  material type, make a notation to that effect under Item 21, Remarks.
LINE 5b. STATEMENT OF LAST CALENDAR YEAR’S OPERATING COSTS



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EF-560-A-R05-0806-41000406-4
BOE-560-A (S2B) REV. 5 (8-06)

         a. Mining and Hauling is the direct cost incurred in drilling, blasting, shoveling, dredging, etc., and hauling to the pri-
                             mary crusher or other point of first processing.

         b. Processing and/or Milling refers to costs incurred in crushing, screening, and washing.
         c. Repairs and Maintenance is all other costs not included in (a) or (b).
         d. Insurance relates to any insurance — fire, casualty, or other — incidental to the quarrying operation.
         e. Overhead is cost of engineering and accounting expense, compensation of officers, and other costs attributable to
                             the quarrying operation, but incurred away from the quarry.

         f. Utilities is power, water and expensed fuel.
         g. Supplies and Materials includes items like stored fuel, repair parts, and office materials.
         h. Other includes costs not accounted for in the above. Do not include non-deductible items, shown in this section, for 
                             any itemized cost category.
LINE 6.  Show reserves at the end of the last calendar year and check one of the boxes for units in which reserves are reported. 
         Reserves are the units of aggregates, either in tons or cubic yards, considered to be mineable in the future under present 
         and future economic and operating conditions.

LINE 7.  Show the year in which you expect the reserves to be depleted.
LINE 8.  Show the surface acreage currently being quarried or mined.
LINE 11. If you plan to mine or quarry in an area not currently involved in your present operation, show date you expect to begin.
LINE 19. Use-Restrictions Affecting Value. Indicate use-restrictions affecting value such as controlled hours of operation, size of 
         machinery and equipment, etc.
Note:  Equipment, materials and supplies must be reported on a Business Property Statement form.

DECLARATION BY ASSESSEE
The law requires that this production report, regardless of where it is executed, shall be declared to be true under penalty of perjury 
under the laws of the State of California. The declaration must be signed by the assessee, a duly appointed fiduciary, or a person 
authorized to sign on behalf of the assessee. In the case of a corporation, the declaration must be signed by an officer or by an em-
ployee or agent who has been designated in writing by the board of directors, by name or by title, to sign the declaration on behalf 
of the corporation. In the case of a partnership, the declaration must be signed by a partner or an authorized employee or agent. In 
the case of a Limited Liability Company (LLC), the declaration must be signed by an LLC manager, or by a member where there is no 
manager, or by an employee or agent designated by the LLC manager or by the members to sign on behalf of the LLC.
When signed by an employee or agent, other than a member of the bar, a certified public accountant, a public accountant, an en-
rolled agent or a duly appointed fiduciary, the assessee’s written authorization of the employee or agent to sign the declaration on 
behalf of the assessee must be filed with the Assessor. The Assessor may at any time require a person who signs a production report 
and who is required to have written authorization to provide proof of authorization.
A production report that is not signed and executed in accordance with the foregoing instructions is not validly filed. The penalty 
imposed by section 463 of the Revenue and Taxation Code for failure to file is applicable to unsigned production reports.






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