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4 (Form 2- Public) <br />5. Describe proposed surface excavation or other land disturbance, including roads, pits, trenches, waste piles, drill pads and <br />collar areas of underground workings, ponds, etc... <br />6. Proposed Disturbance (approximate} .describe the proposed drilling to be conducted, including anticipated number of holes, <br />diameter, depth, location, etc... Submit additional pages if necessary: <br />A. Drill Fads: Quantity __ __ Average Width __.. (ft) Average Length ___ (ft) <br />f3. Drill Holes: Quantity _,,._,.______ Depth .,__. __,_,,. _.` (ft) Diameter (in) <br />C. i~tud :Pits: Quantity _____ Average Width .,__ _ (ft) Average Length _ (ft) <br />Average Depth _ (ft) <br />,Described proposed tnderground work, including reopening of old workings, advancement of adits or shafts, <br />trenches, pits, cuts, rock dumps, or ather types of disturbance, describe type, quantity and general dimensions: <br />D. Other Disturbances (please describe): <br />E. Indicate Chemicals and Fuels used or stored on site. List type, quantity and method to store. <br />._ n - ., <br />F. i~ew Road(s): [~~ length ...__._--- .. t.ft) Width __ (ft} <br />Signi#icantly t;pgraded Roacl(s) Length __--__-._. . (ft} '4t'idth _.. (#'t) <br />Are culverts or other crossings proposed? If so, please describe: ~~,~-_..____________...____________ ..............__..______.___ <br />