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COAL EXPLORATION DRILL HOLE OR WELL ABANDONMENT REPORT <br />This report is filed in accordance with Rule 4.07.3(3) of the Regulations of the Colorado <br />Mined Land Reclamation Board for Coal Mining, adopted in accordance with the Colorado <br />Surface Coal Mining Act, C.R.S. 34 -33 -101 et seq. This report is to be submitted within 60 <br />days of sealing and plugging of all drill holes approved under the specific drilling program. <br />This report can be used for single or multiple holes and can be modified as needed, provided <br />that the information contained in Rule 4.07.3(3) is supplied. Additional sheets may be <br />attached, if necessary. <br />Notice of Intent No.: Date: <br />Project Name: <br />Prospector: <br />Address: <br />County: <br />License of Drill and Rig: <br />COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866 -3567 <br />Rollins #3 Well - North Decline <br />Snowcap Coal Company <br />P.O. Box 1428 <br />Palisade, CO 81526 <br />Mesa <br />Name of Drilling Contractor: <br />(Continued on Next Page) <br />