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COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-3567 <br />COAL EXPLORATION DRILL HOLE OR WELL ABANDONMENT REPORT <br />This report is filed in accordance with Rule 4.07.3(3) of the Regulations of the Colorado <br />Mined Land Reclamation Board for Coal Mining, adopted in accordance with the Colorado <br />Surface Coal Mining Act, C.R.S. 34-33-101 et seg. This report is to be submitted within 60 <br />days of sealing and plugging of all drill holes approved under the specific drilling program. <br />This report can be used for single or multiple holes and can be modified as needed, provided <br />that the information contained in Rule 4.07.3(3) is supplied. Additional sheets may be <br />attached, if necessary. <br />Notice of Intent No.: None (USGS Wells) Date: 10-27-2015 <br />Project Name: USGS Monitoring Well Reclamation (Spring and Cowcamp Creek Wells) <br />Prospector: Peabody Sage Creek Mining, LLC <br />Address: PO BOX 250 <br />Hayden, CO <br />81639 <br />County: Routt <br />Name of Drilling Contractor: Western American Drilling, Inc. <br />License of Drill and Rig: <br />(Continued on Next Page) <br />