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Drill Hole Completion Form <br />BLACK RANGE <br />m r R n , <br />Hole Number: 1-1-i.inotao - / <br />Completion Date: lk \y t 1-011 <br />Total Depth: 9 °) <br />Drilling Company: A 5 1)1 N.- ( <br />Head Driller: ,,, <br />Instructed By Geologist To <br />Cement From (ft): 7 01 <br />Cement To (ft): 3 <br />Total Plug Gel <br />Instructed: 2. S 63 119) hv_f <br />Actual Use: , 00 t J,) ithi1 <br />Total Cement <br />Instructed: iI' lbj blj <br />Actual Use: (D 0 laD Ihf be7/ <br />Geologist's Signature: <br />Head Driller Signature: �� <br />