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T"nSs infor-titian to be filled in by sltc rc.cordert <br />. <br />• ~ <br />_j ' SMF <br />site No. ypy 2) project r <br />nnme_ (_,clc~:vn f~n~lrcod ~ 3) BL`t dis[ri.ct Lrc_ ~_ <br /> <br />• 4) rescurce area Lr'rf1P SnaKP RA 5) planning unit ;,V~elic-mss F. ~ <br />- -- -- <br /> 6) surface management quad ~ MGvf`_1~ nt~l-`~ _ <br /> 7) heritage value (does the site have special significance for ethnic groups i:: the <br /> <br />. area?) Yes_ no ~( <br />r ,. .. ' <br /> <br />.~ This information to be filled•in by~district archaeologist: <br />.. <br /> 8) case file or contract ?Io. C- ~~fo-I3 <br /> 9) sur_°ace ow:cr: BL~f other Federal _ State _ private <br /> 10) subsurface ownership (does BL`1 have responsibility) yes '~ no_ C,c11 o,~}y <br />/ <br /> 11)' grazing unit 4loec l ; ~ 12)2'SP Wait , Unces' Uo~*+, a~ $`~ <br /> .. . <br />_ . 13) segregation ([ype) _ ' <br /> <br /> l 1 mining claim recordation: yes no '15) mineral agency <br /> 16) mineral owr:er~ FLM ~ ~~ 17) mineral part owner Qr••~~cTP <br />' lE) mineral lease 1 19) mineral lease 2 ' <br /> 20) future potential S1 S2 X S3 S4 ''' ~ ~ <br /> <br />~ <br />~ .. <br />.. ~ R*ildlife <br />• <br /> ' caater~!-red <br />minerals <br />range <br />recreation , <br />forestry <br />. lands • X <br />~ "?) mitigation: •.avoid~nan >C collect <br />.' 23) District ArchacoloEist~s siEnaturc <br />r • <br />