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5TATE OF COLORADO <br /> DIVISION OF RECLAMATION, MINING AND SAFETY <br /> �epartm:,nt of�.,;+{ral Rc•u,cr„. <br /> i it 3 incrts Ifin C O L O R A D O <br /> Deriver,CoOrado B020i n i �� u <br /> Phone:c3U3's 866-3 6' RECbkMAT10N <br /> FAX:t30s?h ;:-rioh MINING <br /> SAFETY <br /> MINERAL PROSPECTING DRILLI,HOLE <br /> PERMANF,NT ABANDONMENT FINAL REPORT <br /> Pursuant to the terms of 34-32-113(5.5)(d)and(e)of the Act,all information provided in this report shall be protected <br /> as confidential information by the Mined Land Reclamation Board and shall never be a matter of public record. <br /> Prospect Site Name: Prospect NOI No.: P ✓ - J <br /> Drill Hole I.D. No. <br /> Date Drilled: /' .a 1'- r�'�''= ___. Date Permanently Abandoned: F •1 � <br /> OPERATOR: (PROSPECTOR) DRILLER: <br /> Name: Name: '� l�,.r,•� .�__ — <br /> Address:- 5 e;)l c.'i {) ."'<it r - - - - - Address:_k 7G ti C hf�w f _z" — <br /> City: u,e. St.: 0 Zip: i�'t'` City: /14, :"'Cu 4 St.: ,,n Zip: <br /> -- <br /> Telephone No.: !~ ^� ) `'- u,y yt Telephone No.:( Wj6,. <br /> LOCATION: <br /> The following information is required for all prospecting drill holes: <br /> Va <br /> _ 1 i4 of the — 14 of Section 'q, Township- `�_ 1' Range <br /> Prime Meridian, /; i _--_--------___County. <br /> I r the-area has not been surveyed,supply the Longitude__-_----_-,-_--,.- West and latitude _--_-.-.- North. <br /> or attach a location map. preferably-a i`SUS Quad- <br /> -1 ht foil-m ing additional inli3nmation is regUired 4or artesian 'dolt inn holes: <br /> Distances must he roViciA Ewith an acCL:rae<O -24t1 lect(34-32-113(5.5)(d)) <br /> feet north south from thetsouth north section line <br /> _ feet Dast Ellest from thet west east section line <br /> NOTt : In the case of closely spaced drill holes having similar geologic and hydrologic characteristics,the Operator <br /> ma .x6th the approval of the Division.suhinit a tingle consolidated final report iricludi;ii-,the location of'all <br /> drill holes and a descripti,,n of abandonment technique, In such a case.complete:one abandonment final <br /> ra Ui:,rt tt3rttl and attach a list of drill hoic itications, If more space is needed it) provide any of The <br /> r , - • -. <br /> inte..ft_..` ,1Ti it1, this ta----- l,tessi;21ltaE_1i��I3cii:SiL�i'illtl. <br /> (�illl:F•O� C)titCP Pi <br /> 4+tltMl tu+"t(1lir+clal(Tl<?it„tr iit+1:�.'t a _ict:{U IU{:�I`•.)D • t3UAiity?0 -. r „LreT{R--;CCICE±h4tr1E'� <br />