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3 (FORM 2 -Public filing) <br /> I. LOCATION MAP: Attach a USGS 7.5 minute quad, or similar map of adequate scale, which locates the prospecting <br /> site(s). <br /> J. Are prospect sites(e.g.,drill holes,trench locations,etc...)staked on the ground? Yes No W1 <br /> K. Specify the Land Management Agency,Address and Telephone Number: <br /> Not Applicable - private land only <br /> L. The prospector is required to document that the NOI has been sent to the BLM or the USFS. Processing of the NOI will <br /> not begin until the prospector has submitted evidence acceptable to the Division that the NOI was sent to the BLM or <br /> USFS. Check one: <br /> ® Evidence of notification is attached to this NOI for BLM Land <br /> Evidence of notification is attached to this NOI for USFS Land. <br /> Other proof of notice is attached to this NOI <br /> II. MAPS & DRAWINGS <br /> Accurate topographic base map showing the location of the proposed project must be submitted with this notice. The prospector <br /> may submit a U.S.G.S.7.5 minute quadrangle,or similar map of adequate scale that: <br /> 3. identifies the proposed prospecting site(s)or activity areas involving surface disturbance. Activity areas include all drill holes, <br /> mud pits,excavations,trenches,adits,shafts,tunnels,rock dumps,stockpiles,impoundments and prospecting roads,and <br /> 4, includes sufficient detail to identify and locate known prospecting features and facilities that may be affected and those that <br /> are not anticipated to be affected. This includes the location of all drill holes,mud pits,excavations,trenches,adits,shafts, <br /> tunnels,rock dumps,stockpiles,impoundments and prospecting roads. Color photographs,adequately labeled(including <br /> date,orientation and location),of the prospecting site may be used to fulfill this requirement if included with the NOI <br /> submittal. <br /> III PROJECT DESCRIPTION <br /> 7. Mincral(s)and/or Resource(s)being Investigated: gold,sever,and any other materials that might be found <br /> 8. Estimated dates of commencement and completion: <br /> Commencement: 05/01/2017 <br /> Completion: January 1, 2030 <br /> ' <500 cubic yards <br /> 9. Amount of material to be extracted,moved or proposed to be moved:_ <br /> 10. Identify the type or method of prospecting proposed and quantity(place an"X") <br /> Cuts Pits PAdits <br /> Trenches <br /> hafts Tunnels Declines <br /> / it Drilling ✓ Fluid Drilling Drilling&Blasting <br />