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4 (FORM I - All information.for DRMS use and confidential filing) <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 />�IJ�tt_. 1`61f�ilwTi1ri11}c.� �A � ►� (��G� � M r rr�. 'P� �= Tt�r,� am n f���� <br />1 I N -;C! 0kI M ti 1 P n. �'T r i _V- Alta u D 1, ) A VIt . '715T1A Q-'fN-N C <br />6NLY ON 'DtkNPe <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 Pads: Quantity <br />B. Drill Holes: Quantity <br />C. Mud Pits: Quantity <br />Average Depth (ft) <br />Average Width (ft) Average Length (ft) <br />Depth <br />Average Width <br />(ft) Diameter <br />(ft) Average Length <br />_(in) <br />(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, quantity and general dimensions: <br />r e <br />Lo 0 FULI N6,5 <br />Other Disturbances (please describe): <br />;25 TV) P <br />0u-:WL <br />R mcm oti <br />i�Ew <br />� vr.%= 1' l" 1 Q S PKIA RCKtIv - <br />E. Indicate Chemicals and Fuels used or stored on site. List type, quantity and method to store. <br />F. New Road(s): Length (ft) Width (ft) <br />Significantly Upgraded Road(s) Length (ft) Width (ft) <br />Are culverts or other crossings proposed? If so, please describe: <br />Pt_ &C F— <br />PII <br />