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USDA, Forest Service <br />PLAN OF OPERATIONS FOR MINING ACTIVITIES FS- 2800 -5 (Rev. 12/11) <br />ON NATIONAL FOREST SYSTEM LANDS OMB NO. 0596-0022 <br />Submitted by: <br />USE OF THIS FORM IS OPTIONALI 1 " TIME USERS SHOULD DIRECT QUESTIONS REGARDING THIS FORM OR <br />REGULATIONS (36 CFR 22iA) TO THE FOREST SERVICE DISTRICT OFFICE NEAREST YOUR AREA OF INTEREST. <br />Signature <br />Title <br />;2 i <br />Date <br />(mm/ddlyv) <br />Date <br />(mm/ddW) <br />Plan Received by: <br />Signature Title Date <br />(mfWddW) <br />I. GENERAL INFORMATION <br />A. Name of Mine/Project: <br />B. Type of Operation: <br />CA (2 '1�1s <br />(lode, placer, mill, exploration, development, production, other) <br />C. Is this a ew/ ❑continuing) operation? (check one). <br />If contin Ing a previous operation, this plan ( ❑replaces/ ❑modifies/ ❑supplements) a previous plan of <br />operations. (check one) <br />D. Proposed start-up date (mm/dWyy) of operation: D .20 <br />i <br />E. Expected total duration of this operation: / JILL() '4 <br />F. If seasonal, expected date (mm/dd/yy) of annual reclamation /stabilization close out: <br />G Expected date (mm/dd(yy) for completion of all required reclamation: <br />II. PRINCIPALS <br />A. Name, address and phone number of operator: <br />a 4,y � 7/1 5-3o v (D$$") <br />B. Name, address, and phone number of authorized field representative (if other <br />Attach authorization to act on behalf of operator. <br />the operator). <br />e;AM <br />C. Name, address and phone number of owners of the claims (if different than the operator): <br />[a <br />(If more space is needed to fill out a block of information, use additional sheets and attach form) <br />so <br />:2_0a <br />