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5. <br />c <br />a <br />G <br />6. <br />4 (Form 2- Public) <br />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 />_ . \ 1 Q l <br />_C1.?•Se??_.._ ?...... `1?°.'.'.....14.?_.. ^bGAS --ce_ ?,-?c.`. <br /> _ce, c\' Tt'- sue„ `e-ceS -VceeS?aT4 <br /> <br />r r... Ac,,` i co « _. ?..!1.. Nq' 'jeCX5 a_. AM e- '-'7' r--, <br />wo.y C-S 1a S?re?ejl? c ecoS%G-fN', <br />d number of holes <br />ti <br />i <br />t <br />di <br />d <br />d <br />i <br />l <br />li <br />b <br />Proposed Disturbance (approximate) Describe th , <br />c <br />pa <br />e <br />u <br />ng an <br />e con <br />ucte <br />, <br />nc <br />ng to <br />e proposed dril <br />diameter, depth, location, etc... Submit additiona l pages if necessary: <br />A. Drill.Pads: Quantity ___$ Average _ _____(ft) <br />Width elU _ (ft) Average Length <br />B. Drill Holes: Quantity ?S Depth t <br />d 0 (ft) Diameter <br />C. Mud Pits: Quantity Average Width (ft) Average Length _ (ft) <br />Average Depth O <br />Described proposed underground work, including reopening of old workings, advancement of adits or shafts, <br />trenches, pits,.cuts, rock dumps; or oth e r types.nfdisturbance, describe type, quantity and general dimensions: <br /> <br />.-..._.......- <br />v <br />- ---__ <br />-------------- __ <br />- ?- <br />- <br />D.. Other Disturbances (please describe): <br /> <br /> <br /> <br /> <br />E. Indicate Chemicals and Fuels used or st ored on site. List type, quantity and method to store. <br />V-1 A <br />?c.?5 <br />4•-r <br /> v <br /> <br /> <br />F. New Road(s): Length (:ft) Width (ft) <br />Significantly Upgraded Road(s) Lengt h L00 0(ft) Width ,_,_b (ft) <br />Are culverts or other crossings proposed? If s <br />j?os4--, , please describe: <br />,._ 5 c? h .- etas; ar r??,.eS <br />_0A VeM? <br /> <br />.s?^c S <br />