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I. LOCATION MAP: attach a L - S minute guild. 01 similar map of adequate scale. which locates the prospecting <br />51ie(s ) <br />J. Ale prospect sites to g.. dull holes. trench locations. etc ) staked on the ground' Yes No L <br />K Specify the Land Management Agency. Address and Telephone Ntunber: <br />USFS,Mr. Mike Johnson <br />2140 Yarmouth Ave. <br />Boulder. CO 80301 <br />L The piospectoi is required to document that the :COI has been sent to the BLM or the USFS Plocessmg of the NOI will <br />not begin until the prospector has submitted evidence acceptable t0 the Division that the NOI was sent to the BLM 01 <br />I SFS Check one: <br />II. MAPS & DRAWINGS <br />Evidence of notification is attached to this NOI for BLM Land <br />Evidence of notification is attached to this NOI for USFS Land <br />Other proof of nonce is attached to this NOI <br />Accurate toposiaphic base map showing the location of the pioposed protect niust be submitted with this notice The prospector <br />may submit a L S G S. - 5 nnn quadrangle. or smulai map of adequate scale that <br />3. identifies the pioposed prospecting site( s) or activity" oleos involving swine disturbance Activity oleos include all dull holes. <br />inud pits. excavations. trenches. adits. shafts. tunnels. lock duunps. stockpiles. impoundments and prospecting roads. and <br />4. includes sufficient detail to identify and locate known prospecting featui es and facilities that may be affected and those that <br />ale not anticipated to be affected This includes the location of all dull holes. iuud pits. excavations. Clenches. adits. shafts. <br />tunnels. lock dumps. stockpiles. impoundments and prospecting loads C olor photographs. adequately labeled I includulg <br />date. olientation and location). of the prospecting site may be used to fulfill this requirement iI included with the NOI <br />submittal. <br />III PROJECT DESCRIPTION <br />llineral(s) and or Resource(s) being Investigated: Gold. silver and other base metals <br />S Estimated dates of commencement and completion: <br />C ou eme nt 05/0112012 <br />C ompletron. 10/15/2013 <br />325 00 <br />9 Amount of material to be extracted, moved or proposed to be moved: <br />10 Identify the type 01 method of prospecting proposed and quantity (place an ••_l "•) <br />Cuts <br />hafts <br />u Drill= <br />Pits <br />Tunnels <br />Fluid Dulling <br />(FORM 2 - Public frlinQ) <br />_Ti enches <br />Adis Declines <br />Diillillg C Blasting <br />7 <br />X <br />