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2 (FORM 2 -Public filing) <br /> RANGE(write number and check direction) R94 East West <br /> QUARTER SECTION(check one):]NEWV( ­NEE' <br /> NSE SW <br /> QUARTER/QUARTER SECTION(check one): W SEF SW <br /> GENERAL DESCRIPTION:(the number of miles and direction to the nearest town and the approximate elevation): <br /> West Side Placer Bulk Sample is located approximately 1/2 mile south from County Road 4 on County Road 88;.8 miles due south of the Wyoming state line. <br /> NOTE: Supply longitude and latitude or UTM coordinates if lands have not been surveyed or as supplemental information to <br /> this NOI. GPS measurements will be acceptable for this purpose: <br /> 40059'27.98"N 1107054'4.51"W <br /> 11. LAND O RSHIP Private Public Domain(BL National Forest(USFS) ❑ <br /> State State Sovereign Lands Other(please describe): <br /> If prospecting is located on BLM or USFS land the remaining section must be completed, <br /> otherwise go to section II Maps& Drawings <br /> 12. PROSPECTING ON BUREAU OF LAND MANAGEMENT(BLM)LAND AND U.S.FOREST SERVICE(USFS) <br /> LAND <br /> The Division and the BLM/USFS have entered into cooperative agreements that eliminate the need for a prospector to post a <br /> financial warranty with each agency and allow them to coordinate the review of the NOI in order to minimize administrative <br /> processing time and effort. <br /> G. CLAIMANT: <br /> Name: <br /> Address: <br /> Telephone: <br /> Fax Number: <br /> H. SITE/CLAIM INFORMATION: <br /> List names, serial numbers and provide legal description to nearest quarter-quarter section of all sites or claims (attach <br /> additional page,if necessary). <br /> NAME SERIAL NUMBER LEGAL DESCRIPTION <br />