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-4- <br /> 14. If this operation will use designated chemicals, or will result, or presently has acid mine drainage - you cannot use this <br /> application form. You must submit a either a 110d or 112d application form for Designated Mining Operations. In either <br /> case, you must list any acidic or toxic-forming materials, exposed or disturbed as a result of the mining operation, and <br /> whether the operation will result in or presently has acid/mine drainage: ,(,, <br /> �ere u,re n o QC IGw ar �P7CiG- ] &rrn; Q /KOL&C,/S CIA I e.. 7;(e_ <br /> /S r cow n rt ve <br /> i t to nt o e •c S <br /> e e _ajeal ZZee Is <br /> 15. Description of Conversion: If you are converting an existing operation, provide a brief narrative describing the proposed <br /> change(s): <br /> -1 h Q/( G�Yt AI SAL/ LZ.P�/'�4�t•OY� <br /> 16. Maps&Exhibits: Submit two(2)complete,unbound copies of the following application exhibits: <br /> 6.3.1 EXHIBIT A-Legal Description and Location Map See Fgvre 1 Z 6LYq Em-rV. Assess-e-� <br /> 6.3.2 EXHIBIT B-Site Description — Sstt (3 P, fE;,V;r 4ss' <br /> 6.3.3 EXHIBIT C-Mining Plan ---0'*Ae)_ or�gtna' rnet Tt�-�ttr.. a.P,ar�o� ll��-/ �e0.er <br /> 6.3.4 EXHIBIT D-Reclamation Plan P°Yt -f PI.L, of <br /> 6.3.5 EXHIBIT E-Map <br /> 6.3.6 EXHIBIT F-List of Other Permits and Licenses Required /Plan oTL � �C �e�a12° a� <br /> kL- <br /> 6.3.7 EXHIBIT G-Source of Legal Right-to-Enter AAL — GLM- !o Aer- ffr� 4A&Ifted- <br /> 6.3.8 EXHIBIT H-Municipalities Within a Two-mile Radius <br /> 6.3.9 EXHIBIT I-Proof of Filing with County Clerk min�; elatt� t^/rtC,Z rf 8���- -'.Sam Lt Aft <br /> 6.3.10 EXHIBIT J-Proof of Mailing Notices of Permit Application <br /> 6.3.12 EXHIBIT L-Permanent Man-Made Structures nl� <br /> 6.5 Geotechnical Stability Exhibit(as required) A/ <br />