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NOTE: Supply longitude and latitude or UTM coordinates if lands have not been surveyed or <br /> as supplemental information to this NOI. GPS measurements will be acceptable for this <br /> purpose: <br /> Lat: 39to5011- 36/, A/ X: <br /> Long: IoLo3a:�2 h/ Y: <br /> 6. LAND OWNERSHIP: / <br /> Private Public Domain (BLM) © National Forest(USFS) <br /> State State Sovereign Lands Other (please describe) <br /> If prospecting is located on BLM or USFS land the remaining section must be <br /> completed,otherwise go to section II Maps&Drawings <br /> 7. PROSPECTING ON BUREAU OF LAND MANAGEMENT (BLM) LAND AND U.S.FOREST <br /> SERVICE (USFS) LAND <br /> The Division and the BLM/USFS have entered into cooperative agreements that eliminate <br /> the need for a prospector to post a financial warranty with each agency and allow them <br /> to coordinate the review of the NOI in order to minimize administrative processing time <br /> and effort <br /> A. CLAIMANT: <br /> Name �Pnol\lJ, l i S S6 <br /> Address �1 3"1 Pr j 1.J-re kn ed 3 5c/ <br /> City, State,Zip P1'C-dM"T—' OIL) n395/ <br /> Telephone W V,3 LZ2 3 �,25b 0r 3W - 605751 <br /> Fax n <br /> Form 2—Public File Page 3 of 14 <br />