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~/l GllnlJLLJ ~.IL f...rv +.. ...~r... .. .~ <br />PIINE NUMBER L IS THIS A NEW OPERATION^ <br />Will Permits be required? Diesel <br />Mine or Operation Name Carbou.]m tim Mtn Explosive <br />• OWNER <br />Name Oakrldge Enery:y Inc. <br />Address 4I1 F rG Na tonal Rank ]g,ilding <br />70R 8th Street <br />W tohita Fa-ls~ Texas 7fi l(11 <br />Telephone ( R17) 122- 4777 <br />OPERATOR <br />Oakridy~e -ner6Y Tnr. <br />77R Sawyer nrlvr~ S,.i,e lA <br />nn~~-a nvn~ rnlnraAn A17(ll <br />(3D3) 7A5 -1aL51 <br />(check one) Corporation (g}) Partnership ( ) Individual ( ) <br />(If Incorporated or partnership complete section XX) <br />(List all Contractors complete section yy) <br />LocatLon of operation <br />1/-1 Section SF/4 Section ~_ Township 7L~1/pNRange~_ <br />County ),;, 1'lara County No. N/A <br />Person ~n char_ae J+m ~laDdrlcYa Telephone (~~1 gR~-~y~} <br />Address na4ridgo Tinargy Inc Title -AlanageF-__ <br /> 77A Ca....n .~ ,1~1.. e G.1 fu lA <br /> n,.,-.,..,,,. ~,.1,... ..a.. A ,7n1 ZIP ~~ <br /> STATI'S (check one) <br />Producing ( ) Exploring ( ) Developing ( 1 <br />.abandoned ( ) Idle (XX) Rehabilitation ( 1 <br /> fiIND OF OPERATION (check one) <br />• <br />dine ( 1 Surface Mine b{7C) Placer ( - Mill ( I <br />Prep Plant ( ) Tunnel ( ) Tourist ( ) `fine & `lilt/F1ant ( 1 <br />Underground Surface mine Surface Facility <br />\verage number of employees ( ) ( _ ) ( _ 1 <br />Opera'AtAion will be conducted ( _) days a week 1 _) hours a da-y <br />/II IlV~ ,5 1D~6 , (_) weeks per year <br />LIST OF PRODUCTION (check all that apply) <br />Coal (gx) Gold ( ) Gem Stones ( ) Lead ( I <br />Sil~-er ( ) Molybdenum ( ) Zinc ( ) Cadmium 1 , <br />Uranium ( I Vanadium ( ) 011 Shale ( ) Col,l~er ( 1 <br />Tungsten ( ) Tourist 1 ) Rock 1 I ( 1 <br />C~ <br />State where incorporated <br />President/Partner 1 <br />Vice President/Partner 2 <br />Secretary/Partner 3 <br />Treasurer/Partner 4 <br />Section (SS) <br />utah ; <br />-nul n~ ,r~L,...1''' <br />C2ndr3 D-.~eve••'-e..~ <br />~afld= , n_,~--ram.. x,.1„3. <br />Name <br />Address <br />SECONDARY CONTRACTOR'S Section I)y) <br />Nune Selected -Ph~*+ <br />ZIP <br />Telephone ( _ ) _- <br />Date of thi report 12/ 8/92 Title CunsultinK Entzineer <br />Signature ,Gi Name _~arry A. Fargucan <br />(yes/no) <br />~- <br />DEC 1 p 1992 <br />