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MARK CHURCH
EF-560-A-R05-0806-41000407-1 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-R05-0806-41000407-2
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-R05-0806-41000407-3
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-R05-0806-41000407-4
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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