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c? <br />4 <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 . necessary: /VIA Tunoe.4 s <br />A. Drill Pads: Quantity A JA Average Width (ft) Average Length (ft) <br />B. Drill Holes: Quantity __"_ Depth _ (ft) Diameter (in) <br />C. Mud Pits: Quantity ._41A Average Width (ft) Average Length __ (ft) <br />Average Depth VA (ft) <br />Described proposed underground work, including reopening of old workings, advancement of adits or shafts, <br />trenches, pits, cuts, rock dumps, or other types of disturbance, describe type, antity and general dimensions/, fo ft" <br />raspe d /o o aassib?? b . <br />r <br />Po C IV Z <br />:1- ?e lO OD -0 6 fo get <br />s e t a X N d ?. ? <br />Pro 4 <br />L I2 a in/ -t u?c?t^e, pdsS i 6 x o $fj' <br />D. Other Disturbances (please describe): <br />F. New Road(s): Length <br />(ft) Width {ft} <br />Significantly Upgraded Road(s) Length (ft) Widths (ft) <br />Are culverts or other cros ings propRsel If so, please describe: /V f A <br />E. /Indicate Chemicals and Fuels used/or stored on site. List type, quantity and method to store. <br />f- 41- <br />r - <br />- To,