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PLAN OF OPERATIONS FOR MINING ACTIVITIES FS 212/i1)(Rev. <br /> USDA,Forest Service OMB NO.0596-0022 <br /> ON NATIONAL FOREST SYSTEM LANDS <br /> II SF OF THIS FORM IS OPTIONAL <br /> REGULATIONS(36 CFR 228A)TO THE FOREST SERVICE DISTRICT OFFICE NEAREST YOUR`AREA <br /> OFFIINTEREST. <br /> Submitted by: / ,�" $ �`v.�. �- 216J <br /> Signature Title Date <br /> (mrr✓ddlyy) <br /> Signature Title Date <br /> (mmlddlyy) <br /> Plan Received by: lcM S — GCS �� 1 <br /> n ur S a Title Date <br /> (mm/ddlyy) <br /> I. GENERAL INFORMATION <br /> A. Name of Mine/ <br /> Project: <br /> B. Type of ; <br /> Operation: <br /> (lode,placer,mill, exploration, development,production,other) <br /> C. Is this a(new/continuing)operation? (check one). <br /> If continuing a previous operation,this plan(replaces/modifies/supplements)a previous plan of operations. <br /> (check one) <br /> D. Proposed start-up date(mm/dd/yy)of <br /> operation: <br /> E. Expected total duration of this operation: ✓o A `� <br /> F. If seasonal,expected date(mm/dd/yy)of annual reclamation/stabilization close <br /> out: �I �_ <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: 1 7 <br /> B. Name, address, and phone number of authorized field representative(if other than the operator). <br /> Attach authorization to act on behalf of operator. <br /> (If more space is needed to fill out a block of information,use additional sheets and attach form) <br /> -1- <br />