2024-12-16_REVISION - M1977410 ‎(28)‎

• Permit No: M1977410
• IBM Index Class Name: Revision
• Doc Date: 12/16/2024
• Doc Name Note: Appendix U-1 Cross Gold Mine MCP
• Doc Name: Request For Conversion
• From: Grand Island Resources LLC
• To: DRMS
• Type & Sequence: CN1
• Email Name: JPL
• Email Name: JLE
• Email Name: EL1
• Email Name: LJW
• Email Name: THM
• Media Type: D
• Archive: No

CGM - MCP
November 2024 12

Pumps and valves are locked if not in use
Response Equipment
Response equipment inventory is complete

Date: ____________ Signature: _________________________