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-4- <br /> 14. If this operation will use designated chemicals, or will result, or presently has acid mine drainage - you cannot use this <br /> application form. You must submit a either a 110d or 112d application form for Designated Mining Operations. In either <br /> case, you must list any acidic or toxic-forming materials, exposed or disturbed as a result of the mining operation, and <br /> whether the operation will result in or presently has acid mine drainage: <br /> wi ARE 6_r&&t vG, fMAt t (9x gFr 2 fro Es A ,,0 irlL e yz5- werr,,l H,4AIP rooms, 2/t.e_r <br /> WrCt Bt NO MACH/S.-L r/5,J5. Ny LPcMLC4[S Nd t.ICABcE. T�/GRL u/IGe­NF'12-7/L Bc <br /> /lay USED ZN T1-/lS f-/R,v/)to t_ a,vcY©pZ 1r,4rz;,, ! A/ANO T.�c s <br /> QNLy WLtL gG </SL�O TII CI�T/L�¢GT Pttv��j�d�s/?fCrMEvs- ,E'/c�CLA?�1�Tr0✓ L✓Zc� Co.�S.TSTOr <br /> BA k4Es044,,o SuAYsN6, Ac4p, 0al0c}'yrtAr'-f, <br /> TL_-R E ro/z lyea_ N6, ra MZ 7-x 4 47—Ala e tJr;RN�iEkS dN c;a/2�t��M/F��;✓E���BBC/�rtccz�,Hu Es <br /> 15. Description of Conversion: If you are converting an existing operation,provide a brief narrative describing the proposed <br /> change(s): <br /> &A PA'-'Ir C✓xZ5rz&A 0PE24rZ4iv5 O / 4:)v2 yNcy A644 ky6z Psis rlw <br /> 16. Maps&Exhibits: Submit two(2)complete,u4bound copies of the following application exhibits: <br /> 6.3.1 EXHIBIT A-Legal Description and Location Map <br /> 6.3.2 EXHIBIT B-Site Description <br /> 6.3.3 EXHIBIT C-Mining Plan <br /> 6.3.4 EXHIBIT D-Reclamation Plan <br /> 6.3.5 EXHIBIT E-Map <br /> 6.3.6 EXHIBIT F-List of Other Permits and Licenses Required <br /> 6.3.7 EXHIBIT G-Source of Legal Right-to-Enter <br /> 6.3.8 EXHIBIT H-Municipalities Within a Two-mile Radius <br /> 6.3.9 EXHIBIT I-Proof of Filing with County Clerk <br /> 6.3.10 EXHIBIT J-Proof of Mailing Notices of Permit Application <br /> 6.3.12 EXHIBIT L-Permanent Man-Made Structures <br /> 6.4.19 EXHIBIT S-(as required) <br /> 6.5 Geotechnical Stability Exhibit(as required) <br />