Mineral Exploration Progress Report (Page 2 of 3) in pdf

Mineral Exploration Progress Report Page 2

DRILL HOLE SUMMARY REPORT

Permit #:

E/_____/________

Project Name:______________________

Complete this Portion Only if Water Encountered

All Dry Drill Holes are plugged with a 5 foot cement plug

Fill out Page 2 if water is encountered for EACH wet hole

Pre

Final

NAD 27 GPS

Depth

Total

Date

Flow

Date

NOTES

Drill

Depth

Drilled

Rate

Plugged

(Describe how plugged, Artesian, etc)

Hole

Northing

Easting

(Feet)

(mm/dd/yyyy)

Water

(GPM)

No.

A Registered Professional Geologist in the State of Utah or a Certified Professional Geologist with the

AIPG or an officer of the company registered to do business in the State of Utah must sign this form if the form

is being used to request release.

I certify that the reported information, statements, and/or documentation on this form are true and

correct to the best of my knowledge and belief.

STAMP

Name ________________________Title________________ PG or CPG License No.__________

Signature ___________________________________________ Date ________________

Mineral Exploration Progress Report Page 2