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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman , Room 215 <br />Denver, Coiot;ido 8(120 3 <br />Phone. (303) 866 -3567 <br />FAX: 1 303) 8 -8106 <br />Prospect Site Name: 5011 tT0.1Ah SC lve f P( <br />Drill Hole I.D. No. / 0 901- <br />Date Drilled: 10 - lb lfi 11- <br />OPERATOR: (PROSPECTOR) <br />Name: 8.1;, G ra mie, / S Silver <br />Address: 11 . 1 z STre ^^ �' -- L _�._... <br />City: C' e eck St.: CO Zip: 9113 O <br />Telephone No.: (_71 ) 6 5 - !6 Res <br />Other rp <br />Mired L.Inrl Re; I.uirattiii <br />MINERAL PROSPEC'fIN(I DRILL, HOLE <br />PERMANENT ABANDONMENT FINAL REPORT <br />Date <br />LOCATION: <br />"Me following information is required for all prospecting drill holes: <br />S E 1/4 of the _ E 1/4 of Section , Township 42 N <br />NM Prime Meridian, M In j at_ <br />County. <br />If the area has not been surveyed, supply the Longitude West and Latitude <br />or attach a Iocation map. preferably a USGS Quad. <br />The following additional information is required for artesian flowing holes: <br />Distances must be provided with an accuiacy of :x200 feet (34-32-113(5.5)(d)) <br />_. _, feet ( ) north ( ) south from the ( ) south (' ) north section line <br />feet ( ) east ( ) west from the ( ) west ( ) east section line <br />COLORADO <br />1) l y t 5 1 t7 N O <br />RECLAMATION <br />MIN i NG <br />— &— <br />SAFETY <br />8 :11 R•n 't. <br />Govern•e <br />ri.ur i. 0. Sherman <br />r•�rv:;I. tie Dtrec.. <br />Pursuant to the terms of 34-32-113(5.5)(d) and (e) of the Act, all information provided in this report shall be protected <br />as confidential information by the Mined Land Reclamation Board and shall never be a matter of public record. <br />Prospect NOI No.: P- ZOO 9 - 0 Z b <br />Ronald W. Callan., <br />Divi •inn D•u•r for <br />N, tural RFSOOH r• rrobtee <br />Permanently Abandoned: 11 - 8- 2 0 0 1_ <br />D RI LLE R: <br />Name: COh <br />Address: 219 11. 10.01 $ e hd Ave <br />City: l f05e St.: CO 'Lip : 01 <br />Telephone No.: c 9701_ Zt 9— 3SIN <br />Range 1 Vsl <br />North, <br />NOTE: In the case of closely spaced drill holes having similar geologic and hydrologic characteristics, the Operator <br />may, with the approval of the Division, submit a single consolidated final report including the location of all <br />drill holes and a description of abandonment technique. In such a ease, complete anti abandonment final <br />report form and attach a list of drill hole locations, If more space is needed to provide any of the <br />intorntat.ton for this f(.rrn. please attach lit :paralc sheets <br />Oliu t• to <br />3;c11 • Grand lunciion • tiut.ingo A( :• ,m•_ Irlat :6ve 1,1uti , <br />