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.,r ~ OF . t.p~~~ <br />rr~ ~~/'~' 90 <br />,~ O <br />~v <br />,~~. <br />~ X876 j <br />Ric nar0 D Lamm <br />GOrernor <br />DEPARTMENT OF NATURAL RESOURCES <br />0. Monte Pascoe. Eaecuure Director <br />MINED LAND RECLAMATION DI <br />DAVID C. SHELTO N, Director <br />This report is filed in accordance with Rule 4.01.3(3) of the Regulations of <br />the Colorado Mined Land Reclamation Board for Coal Mining, adopted in <br />accordance with the Colorado Surface Coal Mining Act, C.R.S. 34-33-101 et se . <br />This report is to be submitted within 60 days of sealing and plugging o~a~ <br />drill holes approved under the specific drilling program. This report can be <br />used for single or multiple holes and can be modified as needed, provided that <br />the information contained in Rule 4.07.3(3) is supplied. Additional sheets <br />may be attached, if necessary. <br />Prospector: <br />r0~ Ct7 c.l \ ~ J [.~.~ (~ 4 K <br />~~tt~~ Y `~ <br />Address• 1SJvK~-r= ev <br />C C~ <br />Notice of Intent No.: ~ / ~ ty: <br />Cou ~p~ <br />. <br />Project Name: INa`iev ~ oh,~ov t n <br />ya ~ ~ ~ ~c1 Q <br />~c~tiln.,o l..-~ 5 / ~~~ 6 <br />Date: ~Z -.S' ~[~ <br />Name of Drilling Contractor: <br />License of Drill and Rig <br />(Continued on Next Page) <br />(Rev. 5/83) <br />Doc. No. 3018 <br />a23 Centennial Building, 7373 Sherman Street Denver, Colorado 80203 Tel. (303) 866-3567 <br />