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~~ a ~-~' Fi~ILITY LOCATION SKE~H III ~II~II~II~~II III <br />e sss <br />LI,~I'1l:ild O(J lJQf LJrII:I: 'i. .'/1`j/ti1d U'J: firy Frill U.~(!1/.' I'Ln<I ,FI_. I~r.)L, <br />U. iginal I_a].7. Ud~iE: t~/J`i/'jai lime: r.r..~~~ ~.p: I-I; <br />r~uesied F~,r lla~e: 1~/1//9d f Imr=: r-16:~~~ ,-r--_ .,_ - <br />i.l~,n~-;rh~dl.l! inq member~a pleases r,lE-ei 27. rF.y,i,~Sr~Li ~ , <br />`;: =1;,e3 CU I_ounty; CHHhi-tc I_)ty. <br />Addr: _•_4B5'i S~~ree'c: U5 1,41'? ._b~ <br />Nt:•~.r Ir, i. er ~f=rL lnn tsi: Ud HJr t-6 <br />IDr ld ,: 1JnUiCiW!Itbinl iJ.7 tl/dWV ,:a: _.Yl, .•, ~ ~ ,., <br />'type r_,f Work: IvEW I~r•:H4tl. f ! I <br />Lo~:ai~..m: LUI_ 6h1131~a I,kwvtL rI I ~.-., ,. .. , <br />11-IcN ICU TU bh:HVEL F'I I IFI,-+. _,._L~~~.= I I ~_ <br />.. .. .:rl9t[cT Hl FI L•UVt I7UUI': H 1 b:.~ .'I , i~_, .. ' <br />UUN~ 'auUnlEl? Ur,LL H/U iU ~.uNr L.:,l <br />_nnpany JL't IUh:-th! H/U <br />cone f~_, SEu- <br />F'eme~r Va.. <br />i lemac-r s JUhIMY 1 . SlltLUl ~SWI_ u6 <br />i <br />.RECEIVED <br />'• JAN 11 1999 <br />RECEIVED ov,s;onotMineralsBGeology <br />JAN 11 1999 ~ ~ ~ -~. <br />%wslon of Minerals 8 Geology <br />LARRY 13c6ssDr £a....- <br />CAUTION. MECHANICAL DEVICES ~ PRWATE FACILpTI SLMAVLBE PRESENTS NODIG AIREANCHECK W TH PROPERTY OWNER.SE ALL FACILITIES BEFORE OSING <br />AREA /1 MEET TIME t, /1 ~ J TIME ARRIVED ~/ ~i TIME COMPLETED <br />How MSrketl: ^Paint `O FlepeiON_ylon WMeMen Prlntl <br />LJ) ~ 1~ <br />~~ ~~~ / <br />l/ ~\ ~ <br />^ DIG ALERT <br />Malor leelllly In or near tllp <br />area. Plsese hentl tllq entl <br />sepoee sll lecllltles or cell Kelly <br />Locate Depl. for seeletencs! <br />^ Standby Required <br />Copy left at site <br />/EXCAVATOR NOTIFIED <br />Name <br />Dale: / / Time. AM PM <br />Log/ <br />FACILITY OWNER NOTIFIED <br />Dale: / / Time AM PM <br />)IG AREA vMn'' „moV.o FENCE <br /> <br />_~ <br />LOCATOR INDICATE NORTH <br />COLOR CODES: <br />s (2) Gae -Yellow 13) Electric - Retl (4) Cable N -Orange (5) Wetr <br />I(IMATE: <br />n <br />•~ ~ _ DATE ~ ~~~ / <br />EXCAVATOR <br />Sewer - Gresn <br />Phone - <br />COMMENTS <br />LOCATOR'S NAME / <br />L <br />Signature of person on job site <br />EXTENDED JOB AGREEMENT <br />Our company and I agree that this original locale <br />ticket Is an ex1entled lob and that locates will be <br />tlone on a tlay.lo4ay basis. No excavating will <br />take place until signetl paperwork is receivetl by <br />our Company wish the dig area defined. <br />Excavators Signature <br />