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R <br />4. Did any drill holes experience surface artesian flow conditions? No <br />If yes, locate these holes on a map and describe sealing and plugging procedures that <br />were used. <br />5. Were any drill holes converted to a water well? No If yes, list the State Engineer's <br />Well Permit Number and name and address of the user. <br />6. Does the prospector wish this report to be considered confidential? <br />(See Rule 2.02.7(s)). No If yes, attach a justification for the request. <br />7. Additional Comments: (See Attached) <br />I, the undersigned, hereby certify that the exploration activities for which I posted bond <br />are completed, and that, to the best of my knowledge, al licable reclamation <br />requirements have been met. <br />By: Pvt. <br />Title: ~ ~ ~ e<~oy- ~ ~ a-''-'-~~ <br />Authorized Oper or Representative <br />The foregoing instrument was acknowledged before me this ~ day of <br />Operator. <br />My Commission Expires: <br />laiool Myri®ffif~laslonEY <br />~s2nolo <br />-. <br />ATTPkC3'rYl!'JFN-~=' ~` ~ ~ A <br />"~i . ' <br />Notary Public <br />