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-4- <br />14. if this operation wilt use designated chemicals, or will result, or presently has acid mine drainage -you cannot use this <br />application form. You must submit a either a 110d or 112d application form for Designated Mining Operations. In either <br />case, you must list any acidic or toxic-forming materials, exposed or disturbed as a result of the mining operation, and <br />whether the operation will result in or presently has acid mine drainage: <br />15. Description of Gonversian: If you are converting an existing operation, provide a brief narrative describing the proposed <br />changes}: <br />16. Maps & Exhibits: Submit two (21 complete, unbound conies of the following application exhibits: <br />ti.3.1 EXHIBIT A -Legal Description and Location Map <br />G.3.2 EXHIBIT B -Site Description <br />6.3.3 EXHIBIT C -Mining Plan <br />6.3.4 EXHIBI'T' D -Reclamation Plan <br />G.3.5 EXHIBIT E -Map <br />6.3.6 EXHIBIT b4 -List of Other Permits and Licenses Required <br />5.3.7 EXHIBI'T' O - Source of Legal Right-to-Enter <br />6.3.8 EXHIBIT H -Municipalities Within aTwo-mile Radius <br />G.3.4 EXHIBIT I - Proof of Filing with County Clerk <br />6.3.10 IXHIBT"T .T - Proof of i'Viailing irlotices of Permit Application <br />6.3.1 Z EXHIBIT L - Pernranent Man-Made Structures <br />6.4.14 EXHIBI7° S - (as required] <br />G.5 Geatechnieal Stability Exhibit (as required.) <br />