Work Shaft Sinking Drifting or oother Lateral Work.

_ L30)(

L.",.u,J.m"::m~a:l.ry-ofark Performance and Distrihution of Credits-~I I

Total Work Days Cr. claimed

for Per ormance of the followingwork. (Check one only)

~anual Work

oShaft Sinking Drifting orother Lateral Work.oCompressed Air, otherPower driven ormechanical equip.

o Power Stripping

o Diamond or other Coredrillingo Land Survey

11111111I11I1111111111111111I1132004NES006 WB608-00409 MCGARRY 010

Wor k I-.,,-_--,M'-i nc..,i_n""g7CIa im WorkDays Cr. Prefix f\:umber Days Cr.

Required Informationeg: type of equipment, Names, Addresses, etc. (See Table Below)

Certification Verifying Report of Work

I hereby certify tnat I have a personal and intimate knowledge of the facts set forth in the Report of Work annexed hereto, having purf or rrved the workOr ,:",itnessed same during and/or after its completion 'and the annexed report is true .

. -''-'''''SpecTf,c''information per type

R·ECORDEDNil

Compresseda'r.'othar power Type f equipr&EP 29dr lven O~" rnechantcat equip.

f equipment and amount expended.r~,o.!.1¥if"" cost must be sub"l!lte

36 Wa"Yf(!f'recoPdlng.

.c,.- .• , ••••

Attachments

Names and addresses of men who performedmanual work/operated equipment, together.with dates and hours of employment.

Work Sketch: thesei:lre required to show':he location andI;!xtent of work inrelation to thenearest claim post.

Names and addresses of owner or operatortogether with datas when drilling/strippingdone.

Work Sketch (asabove) in duplicate

NilNil

~anual Work

o Shaft Sinking Drifting or other Lateral Work.

o Compressed Air, other Power driven or mechanical equip.

o Pow er Stripping

o Diamond or other Core drilling o Land Survey

1111111111111111111111111111111 ~/ i

32004NES006 WB608-00409 MCGARRY

Required Informationeg: type of equipment, Names, Addresses, etc. (See Table Below)

Certification Verifying Report of Work

010

Work Days Cr.

I hereby certify tha't I have a personal and intimate knowledge of the facts set forth in the Report of Work annexed hereto, having p Hrformed the wo r k Or ,:",itnessed same during and/or after its completion 'and the annexed report is true.

Type of Work . - -.'--r-SpecTflc"information per type

Manual Work R ·ECORDED Nil

Compressedair, -other power Type f equiprSEP 29 ~rive~ O~" m~chani~a' l equip.

f equipment and amount expended. r~R!1¥if'-'ll1 cost must be sub"2llte

36 Wa"YfC!f'recoPdlng.

Other information (Common to 2 or more types)

Names and addresses of men who performed manual work/operated equipment, togetherwith dat es and hours of employment.

Names and addresses of owner or operator together with dates when drilling/stripping done.

Attachments

'Nork Sketch : these i:lre requ ired to show -: he location and Ii~ xtent of w or k in relat ion to the n earest claim post.

1IV0rk Sketch (as "bovel in duplicate

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Work Shaft Sinking Drifting or oother Lateral Work.

Documents

Transcript of Work Shaft Sinking Drifting or oother Lateral Work.