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.MINED LAD;G'w.t.ui..rE QUESTTO'.•7AI• <br />for limited impact acid select regular mine applications <br />1. I:ame of Company/Mine: Colorado Quarries Inc. Black Obsidian <br />2. Irame/Address/Phone of Contact Person: Bill Tezak P.O. Box 1389 Canon City, CO 81212_ <br />(303) 275-6894 <br />3. Location of Mine: Custer T2~25, R72 W, 6P.M. Sec 16 SE4 of the Nw~i <br />(County, Township, Range, Section to nearest quarter quarter; Exhibit A-*fLR <br />4. Nearest To:.-n/General Location: Ouarrv is 1 (One) mile North Silvercl;ffe c0 <br />5. Land D•~•nership (Circle) 1Q Private 2. BLM 3. USFS 4. Other <br />6. Present Land Use: <br />7. Proposed Final Land Use: Rangeland _ <br />S. Type of Operation: •1~ Surface 2. Underground <br />9. *:inerals being mined: Black Obsidian <br />10. Nurber and Description of Surface Acres Disturbed by Mining/not including roads <br />(Exhibit D-*II.R): 9 acres <br />11. "files of roads to be constructed: None <br />12. Li.`e of ":ine (years) : 20 <br />13. Description of Operation and Reclamation -- Additional sheets may be attached <br />(Exhibits B b E-MLR) _ <br />See attach d ch tc_ <br />14. Please enclose Maps of Project Operation, Disturbance Areas and Recla-.ation (E>:nibit <br />C.) This will expedite processing. Your cooperation is appreciategd. <br />15, Prepared by: _ Date r 7 '~ <br />