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San Juan Drilling Inc. <br /> San Juan Drilling Inc. 57528 Ida Road Montrose CO 81403.970-209-6424 <br /> Drill Hole Abandonment Form <br /> Project Name: <br /> Drill Hole Dates Drilled: ��1 hs' —r" sA Z/is <br /> Azimuth: Dip: — -� Zone: <br /> Drill Hole Location: <br /> Casing Size: Y Casing Depth: 40 , '0W4y <br /> Core Size: 1 T Hole Depth: 56tq <br /> Date Abandoned: '7- 2 6 - /1S <br /> Abandonment Materials Used From To Total depth of Plug <br /> Cement: - go"' k-c&ot <br /> Super Plug: <br /> gentonite: <br /> Grout: <br /> Mixtures: <br /> Drill Hole Making Water: Yes <br /> (contact geologist before abandoning hole) <br /> Cement Plug: Ge No <br /> Survey picket at bore hole: es No <br /> Geologist check site after abandonment Yes No <br /> Photograph: Yes No <br /> Other/Remarks <br /> Driller: Date: -7-24 -/9 <br /> Drill Foreman: Date: <br /> Geologist: <br /> i <br /> I <br />