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OLORADO <br /> ,,TAT OF ----- -- <br /> DIVISION- OF RECLAMATION,-MINING AND SAFETY <br /> E3r`PdRs i''rt tt tiarirai Rc") r,E•, <br /> COLORADO <br /> t f l l.i V <br /> (i i 3 SnE'fMc;n yi..Itt)IJn'-. / ATION <br /> D<,nver.C:oirmldo 1,020 3 RECL; <br /> tiM1NING <br /> Phone:603i' 800-3367 _&, <br /> f.�x: iti3;3�?t's1�6 SAFETY <br /> MINLRAL PROSPECTING DRILI,HOLE <br /> PERIblANENI ABANDONMENT'FIN Al,REPORT <br /> Pursuant to the terms of 34-32-113(5.5)(d)and(e)of the Reclamation Board and Act, <br /> information <br /> shallnever be a matterof publi crecord.protected <br /> as confidential information by the Mined Land <br /> Prospect Site Name: I�E ,__ Prospect NOI No.: P=��I1 - G <br /> c 1- <br /> Drill T:Iolc I.D. No. <br /> Date Drilled: <br /> �+5 f o f Date Permanently Abandoned: <br /> �' --- <br /> OIPEIRATOR: (PROSPECTOR) DRILLER: <br /> f L <br /> r ' Name: — <br /> 7-r���� Address: <br /> Address: <br /> city: ). /,,,�, .r Y�: .r St.:�Zip: i. I City: ��k"/✓l St.:/Zip: <br /> %•- 0,1 Telephone No.: /l 6 ) <br /> Telephone No.: Z ( <br /> LOCATION: <br /> The following information is required for all prospecting drill holes: <br /> `f Township. 4 "' Range %Gc Gs% <br /> SF 1,,4 of the l�6 114 of Section P. <br /> r✓r; r-; Prime Meridian, <br /> If the area has not been surveped,supply the L-ongitude__-__------------------ <br /> Vest and I.atitud< __- :`North. <br /> or attach a location map. preferably a i"S(iS Quad, <br /> t li iC9tlo ing additional int6rrnation is requirct; ii}r artesian flowing holes. <br /> Distances inu,t be rovideti with an accuracy of 200 feet(34-32-113(5.;)(d)i <br /> f eel north south IToi71 thetsouth north section line <br /> —-- ------ <br /> _ feet Elast Ilvest from thet west east section line <br /> !VI ,t-,: In the case of closely spaced drill holes having similar geologic and hydrologic characteristics,the Operator <br /> nla.,l;ith the approt=al of ttte I7iti is:iti�.sul nl+t a,int*le consolidated final report n icludine the location of all <br /> drill hoic-,and a description of abandonmcni technique- In such a case.complete one abandonment final <br /> tttt-ir l�lr;n and attach a list of drill hole locations. It' more space it; needed to tart}Hide any lit the <br /> iilti?riY'si__E)I: It)r i) i;ti liC3Stt:3----- c;f)itic E,f); fJtri£P rf <br /> cyn..cl I dful RP,ld IT):- tiE r;_.r :;tu?uw:tior • Dur_i it,u !,vr r,a Inactive MiI N <br />