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<br /> <br />DEPARTMENT OF NATURAL RESOURCES <br />D. Monte Pacoa. Eaecmrve Director <br />MINED LAND RECLAMATION DI <br />DAVID C. SH ELTONr Director <br />R~cnaro D. Lamm <br />Governor <br />This report is filed in accordance with Rule 4.07.3(3) of the Regulations of <br />the Colorado Mined Land Reclamation Board for Coal Mining, adopted in <br />accordance with the Colorado Surface Co a1 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: ~e ti e c ~., Cis ( ~o ~.... (per, <br />Address: ~ oX G ~ ~ <br />C C~ <br />Notice of Intent No.: fr~ , County: o ~ <br />Project Name• pc~s`~t ~; ~„ p <br />Date: /O-a6 - ~~ <br />Name.of. Dril-ling_Contractor.: _-(~_A _ - _ _ <br />License of Drill and Rig: (~~ <br />(Continued on Next Page) <br />(Rev. 5/83) <br />Doc. No. 3078 <br />423 Centennial Building, 7313 Sherman Street Denver. Colorado 80203 Tei. (303) 866-3567 <br />