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Marsh Funnel viscosity of abandonment fluid: <br />Page 3 of 3 <br />1 -.-771 sec. <br />Type of surface plugging used: --- 1 <br />Depth at which plug set: feet below ground surface, <br />Method: <br />® 2d. Other method used with approval of the Division of Reclamation, Mining and Safety; describe in detail <br />method and materials used on a separate attached sheet. <br />B. CONVERSION TO A WATER WELL. <br />State Engineer's Pennit No.: (attach copy of permit) <br />County Where Well is Located: <br />Water Well Use_ <br />V. METHOD OF RECLAIMING DRILL SITE SURFACE DISTURBANCE: <br />i ne vperawr wno conctucteo the prospecting dnil operation states that the information set forth <br />hereupon is true to the nest of their knowledge. <br />Consulting Geologist <br />(Tide) <br />3/2312018 <br />{nate) <br />