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Drill Hole Completion Form <br />BLACK RANGE <br />Hole Number: [b <br />Completion Date: j 201 <br />Total Depth: J- <br />Drilling Company: £,nA61,1 IDvi I t <br />Head Driller: <br />Instructed By Geologist To <br />Cement From (ft): gt_? <br />Geologist's Signature: <br />Head Driller Signature: <br />Cement To (ft): 0 <br />Total Plug Gel <br />Instructed: <br />G �.S *2) (hs - - <br />Actual Use: � SU y,1s b� <br />Total Cement <br />Instructed: 2,) I o (p f <br />Actual Use: 2 t 100 t r <br />C93 - 5-1-0 ' Z[ LL 14-zo , l bc %) (Q � C ), i5 <br />i-(D? <br />1001 i" --+(^ ce kk, Gad - I b; luL.lavt <br />