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.his infcrnation to be filled in by site recordcrt <br /> <br /> _) sits :;o. `.'C~ 2) project nave' Ce1o`+o Ra~ic-enr 3) BL`t district C~:~: <br /> _ ~ <br /> 4) resource area L~~~1~ ,~~c'^° RP. 5) planni:g unit W~ir~cr*~i -~~`: <br />r ~ 6) surface manager:ent quad Mo., Dell Nty:-~3 _ <br /> <br />.~ 7) heritage value (does.tl:e site have special significance for ethnic groups in the <br />` ' <br />- <br />~ <br />~~ . area?) Yes no ;( <br />'_ - <br />~ <br />_ . <br />z,.. - - <br /> <br />cx <br />This information to be filled in by district archaeologist: <br />8) case file or contract t:o. C.- talc-7.3 <br />:.Y <br />2`. ~ ~ .. _ <br />9) surface oc.-rer: BLK other Federal State ~; private <br />-~ _. <br />' 10) subsurface oo~ersh.i~..(does BL`i have responsibility) yes no,~ <br />.~; <br />,: 11) grai3n'g unit `i(.13 - 12)h?iP unit Uco~r ua~*+pc. 43' <br />-- - ~ V <br />13) segregation (type) _ ' <br />- ! ) .mining claia recordation: yes_ no_" 15) mineral agency <br />~. _ .. <br />16) . mincrai owner- -;~,7cYZ 17) mineral part o:.~er ~~ <br />18) mineral lease 1 - 19) mineral leaso 2 <br />.~ 20) futu-e potential S1 S2 S3_ S4 <br />21) conflicts: - <br />_ , <br />- '. vildli`e .... - - <br />- v~tershed. . <br />- minerals . <br /> <br />i <br />range <br />recreation ~ ' <br />y-- ~ forestry: <br />lands <br />"?)'. mitigation: avc:3 map }collect test-y/Joarti.aliy excavate e::cav:~tc_ <br />'23) District Archaeologist's sidnatu:c. " ' " " " ' <br />