2014-08-12_INSPECTION - M1997032

• Permit No: M1997032
• IBM Index Class Name: Inspection
• Doc Date: 8/12/2014
• Doc Name: Response
• From: Energy Fuels
• To: DRMS
• Inspection Date: 7/8/2014
• Email Name: DMC
• Media Type: D
• Archive: No

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5. APPLICATION AREA:
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a. Area Treated—Based upon 1D Definition: Acres.
b. Area Treated—Based upon Chemical Used or Amount of Chemical Applied:
o . I :zS
c. Status of Application Site(Circle One): 3 Moist
d. Status of Application Site(Circle One): r ative Vegetation Seeded Vegetation
Other Type
b. TARGETED PEST(S):
Name Stage of Growth/Development
FA
c. MONITORING RECORD:
NOTE:
1. This record is required and must be completed,except for monitoring,within 24
hours following application of the pesticide.
2. This is a permanent record and must be kept on filetmaintained at the field office.