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5TATE OF COLOFADO <br /> DIVISIO!� OF RECLAMATION,MINING AND SAFETY <br /> <<�par„•�-�t o;'tianlni Resoarrco- S 10—, <br /> , 5 <br /> i 31 3 S-u=-reran 5'_,Roos;111 <br /> (k 1 <br /> Den-.or,coforado 60-;0 3 ' C O L O R A D U <br /> Phrre: 3.13° Si36-3_6' "1 o f <br /> i RECUMATION <br /> FAX:1303;832-8105 MINING <br /> MINhRAL PROSPECTING DRILI.HOLE jUN 272017 <br /> 2017 <br /> PERMANENT ABANDONMENT FINAL REPORT M01110FAMMATION, <br /> UW AND SAFETY <br /> Pursuant to the terms of 34-32-1 13(5.5)(d)and(e)of the Act,all information provided in this report shall be protected <br /> as confidential information by the Mined Land Reclamation Board and shall never be a matter of public record. <br /> Prospect Site Name: }� ) Prospect NOI No.:P_ 04 <br /> Drill Hole I.D. No. _ _ 2— <br /> Date Drilled: _ Date Permanently Abandoned: <br /> OPERATOR: (PROSPECTOR) tt DRILLER: <br /> Name: C i o f= LC4ilV.�� Name: (� V?v eS6c-�� NVrw"0 <br /> Address:_ goc) /'t A_�1^i Sp/V r4n v/L�_/ Address:_ _� K _0 <br /> City: 1.'em t1•I(e- St.: co Zip: 'S 0�i G' City: p Zip: j��g <br /> Telephone No.: (_7 1� ) Z0 -7 ^ 2,0-7 Z Telephone No.: (_7_a <br /> LOCATION: <br /> The following information <br /> is required for all prospectin drill holes: 80 <br /> Nj.(-! 1/4 of the W 1/4 of Section_ Township_/'n I f✓I I�Range <br /> —=Prime Meridian, ���� <br /> If the area has not been surveyed,supply the Longitude ----------_West and Latitude North. <br /> or attach a location map.preferably-a LT SGS Quad. S rr r4 CG� <br /> The following additional information is revirecl Eiji artesian flowing holes: <br /> Distances must be r(wided.pith an accurac of *200 feet(34-32-1 13(5.5)(d)1 <br /> feet north south from thcnsouth Dnorth section line <br /> feet Oast Dvest from theE]wes[ east section line <br /> NOTE: In the case of closely spaced drill holes having similar geologic and hydrologic characteristics,the Operator <br /> may,k ith the approval oftlte Division.submit a sins�le consolidated fLntil report including-the location ofall <br /> drill holey and a description of abandonment technique. In such a case,complete one abandonment final <br /> report form and attach a list of drill hole locations. If morn: space is needed to provide an, of the <br /> info rniation for this form. p"easi iittaEl separate SIiCCtS. ' <br /> _.____.._._.__._ _—__.___.�..............__..._..___.._______.__. I <br /> Ulllc e o 01w e rl <br /> b+moci I and Rot Irmwu:i Ciemwr Grand lunctior • Durango Inaetl�e 1"4ine, <br /> f <br />