2017-02-21_REPORT - M1977004

• Permit No: M1977004
• IBM Index Class Name: Report
• Doc Date: 2/21/2017
• Doc Name: Annual Fee Notice
• From: DRMS
• To: Homestake Mining Company
• Annual Report Year: 2017
• Media Type: D
• Archive: No

Page 5 of 5

Division records indicate the following permittee/landowner contact information (blank fields indicate that we do not have
information on record). If this information is blank or not current , please type or print current contact information:

Permittee Contact:

Joseph M. Giraudo
Permittee Company:

Homestake Mining Company
Address:

C/o Barrick Gold of North
America, Inc
460 West, 50 North, Ste 500
Salt Lake City, UT 84101

Phone Number:

[phone]
Fax Number:
Email Address:
Permitting Contact:

Joseph M. Giraudo
Company:

Homstake Mining Company
Address:

C/o Barrick Gold of North
America, Inc
460 West, 50 North, Ste 500
Salt lake City, UT 84101

Phone Number:

[phone]
Fax Number:
Email Address:
Inspection Contact:

Joseph M. Giraudo
Company:

Homestake Mining Company
Address:

C/o Barrick Gold of North
America, Inc
4600 West, 50 North, Ste 500
Salt Lake City, Ut 84101

Phone Number:

[phone]
Fax Number:
Email Address:

I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are
being conducted in accordance with the Division approved mining and reclamation plans.

Signature of Permittee, Corporate Officer, Owner, or Documented Designee Date
M-AF-02