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Date <br />7/16/2012 <br />Customer Name <br />CC & V Gold Mining Go <br />Customer Address <br />PO Box 191, N. 3rd st. Victor, CO 80860 <br />c Habitat, Management Inc <br />Time <br />9 30am -12 30pm <br />Environmental Fs Natural Resource Management, <br />Consulting Er Construction Services <br />Location of Application <br />Dump #4 Topsoil Stockpile <br />Target Pests <br />Canada Thistle, Musk Thistle, Yellow Toadflax and Dalmatian <br />Toadflax <br />Site, or Crop Treated <br />Rangeland and Right-of-Way <br />Brand Name/ Chemcal Nacre <br />Pesticide Applied <br />(or Name and Address of <br />Manufacturer) <br />EPA REG # <br />Carrier <br />Method of Application <br />Application Rate <br />Amount Used % <br />(oz) Dilution Rate <br />Tordon 22K (Picloram) <br />Milestone VM (aminopyralid) <br />Telar XP (chlorsulfuron) <br />MSO Premium <br />Blue Dye <br />62719 -6 <br />62719 -537 <br />352 -654 <br />- <br />- <br />Water <br />Water <br />Water <br />Water <br />Water <br />- <br />Backpack Sprayer <br />Backpack Sprayer <br />Backpack Sprayer <br />Backpack Sprayer <br />Backpack Sprayer <br />_ <br />4 pints /acre <br />5 oz /acre <br />2 oz /acre <br />2 pints /acre <br />1 5 pint/acre <br />34 13 oz <br />2 66 oz <br />1 06 oz <br />17 06 oz <br />12 8 oz <br />4 pints /acre <br />5 oz /acre <br />2 oz /acre <br />2 pints /acre <br />1 5 pint/acre <br />16 gals of H2O <br />Date <br />7/16/2012 <br />Weather Conditions <br />Partly Cloudy <br />Wind Direction <br />North <br />Time <br />9 30am -12 30pm <br />Temp <br />65 F <br />Velocity <br />3-5 mph <br />Qualified Superrsor <br />Stephen Guerrero <br />Applicator(s) <br />Nick Mathews & Matt Wertz <br />Comments/ Notes <br />- 40% chance of Scattered Thunderstorms <br />- Equipment is working properly <br />- calibrated to 30 gals /acre <br />Date <br />7/16/2012 <br />Customer Name <br />CC & V Gold Mining Co <br />Habitat, <br />Management Inc <br />Time <br />9 30am -12 30pm <br />Customer Address <br />PO Box 191, N 3rd st Victor, CO 80860 <br />c <br />Environmental Er Natural Resource Management <br />Consulting Er Construction Services <br />Location of Application <br />Schist Topsoil Stockpile <br />Target Pests <br />Canada Thistle, Musk Thistle, Yellow Toadflax and Dalmatian <br />Toadflax <br />Site, or Crop Treated <br />Rangeland and Right -of -Way <br />Brand Name/ Chemcal Nacre <br />Pesticide Applied <br />(or Nane and Address of <br />Manufacturer) <br />EPA REG # <br />Carrier <br />Method of Application <br />Application Rate <br />Amount Used % <br />(oz) Dilution Rate <br />Tordon 22K (Picloram) <br />Milestone VM (aminopyralid) <br />Telar XP ( chlorsulfuron) <br />MSO Premium <br />Blue Dye <br />62719 -6 <br />62719 -537 <br />352 -654 <br />- <br />- <br />- <br />Water <br />Water <br />Water <br />Water <br />Water <br />- <br />Kubota Sprayer Rig <br />Kubota Sprayer Rig <br />Kubota Sprayer Rig <br />Kubota Sprayer Rig <br />Kubota Sprayer Rig <br />_ <br />4 pints /acre <br />5 oz /acre <br />2 oz /acre <br />2 pints /acre <br />1 5 pint/acre <br />64 oz <br />5 oz <br />2 oz <br />32 oz <br />24 oz <br />90 gals of H2O <br />Date <br />7/16/2012 <br />Weather Conditions <br />Partly Cloudy <br />Wind Direction <br />North <br />Time <br />9 30am -12 30pm <br />Temp <br />65 F <br />Velocity <br />3-4 mph <br />Qualified Supervisor <br />Stephen <br />Applicator(s) <br />Tony Matthews <br />Guerrero <br />Comments/ Notes: <br />- 40% chance of Scattered Thunderstorms <br />- Equipment is working properly <br />- calibrated to 90 gals /acre <br />