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n <br />U <br />`J <br />Site No. • SRB1224 Sip,/Field Na. 1979-P77 Page 5 <br />o.s.a.c. <br />42) CDDA <br />a) Recorder's Sigraeure(s) <br />b) State trchaeologist's Signacuze <br />c) Total Persor./Hours spent in the Research for and Prepararioa of ch`_s :cr-s 16 <br />d) Number of Fieldvorkers involved Sn Recording/Prepararioa. 4 <br />e) "out-af-pocket" Ezpeasa : (doeuaenr L' passible) <br />Northern Coal Block Survey <br />f) Project Name _ <br />Northern Coal Company <br />g) Soensoriag/F.aaaciag Agency <br />i) gge or- Tr.ieA Cultural Resource Inventory of the Area around the Northern No. <br />1 I~e to 'Aio , <br />j) State or Federal Permit Nas. 79-CO-034 <br />(She above Cade is"armatioa will be usesul for aaalyzlag ciselmoney :el.acioanhips <br />for survey and site form preparation, and far the federal-state matc.*liag toads <br />program of t::e State AreSaeologist. Thsak ycu.) <br />?J*DITIDNAL I'.4FDR.'~ATION <br /> <br />