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• - 2 - • <br />6. Name of onaer of the subsurface riohta of effected 1sad:Bureau of Land Management <br />7. Name of orner of the surface of affected land: Bureau of Land Management <br />a. Names of the holders of say recorded easements oa the affected land: <br />e. Tvoe of mining oaeratioa: X Surface IIadergrouad Ia-situ <br />9. Location iaformatioa: The center of the area where the majority of mixing will occur: <br />CoDNTY: Rio Blanco <br />PRINCIPAL MERIDIAN (check one): ~L 6th (Colorado) 10th (New Mexico) IIte <br />SECTION (write number): S _3r <br />TOWNSHIP (write number sad check direction): T z North X South <br />RANGE (write number and check direction): R 101 East X West <br />QIIARTER SECTION (check one): NE NW SE X SW <br />QDARTER/QIIARTER SECTION (check one): NS NW SE X SW <br />GENERAL DESCRIPTION: (the number of miles and direction from the nearest town and the <br />approximate elevation): 20 miles South (of Rangely, CO <br />Elevation 6100' <br />10. Primary future (Poet-miaina) land uee (check onel: <br />Cropland(CR) Pastureland(PL) General Agriculture(GA) <br />~ Rangeland(RL) Foreatry(FR) Wildlife Habitat(WL) <br />_ Residential(RS) Recreation(RC) Industrial/Commercial(IC) <br />Developed Water Resourcee(WR) Solid Waste Diapoeal(WD) <br />11. Primary oresaat lead uee (check one): <br />Cropland(CR) Pasturelaad(PL) _;General Agriculture(GA) <br />X Raagelaad(RL) _ Forestry(FR) _ Wildlife Habitat(WL) <br />Residential(RS) Recreatioa(RC) Industrial/Commercial(IC) <br />_ Developed Water Resources (WR) Mining (MN) <br />12. If this operation will uee designated chemicals, or will result, or presently has acic <br />mine drainage - you cannot uee this application form. You must submit either a 110d or <br />112d application form for Designated Mining Operations. In either case, you must list <br />say acidic or toxic-forming materials, exposed or disturbed as a result of the mining <br />operation, and whether the operation will result in or presently has acid mine drainage: <br />13. Deacriation of Amendment or Conversion: <br />If you are amending or converting an existing operation, provide a brief narrative describing, <br />the proposed change(sl: <br />