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NJj y "l THE PENALTY FR MAKING A FALSE STATEMENT IN THIS REPRT AND/R CERTIFICATE IS SS. R SIX MNTHS IMPRISNMENT R BTH Q g 8- K \ n z z? s9 9 - - a. y a Q. 3 Era? 5' n 3 3 C cl ( " t 5- V j 3" a 3 n 0 J. 0. e-'?v k N:.n?\ : f f: : : J J V's J, 5, 'j a CA? a \; rl - ' TJ? ~- w ; - X R V 5? : > : fc 2 HI ' : 1 l 1 1 bs4 3 5J XR \"W?: n x. x t ( s-b " s? fc! : ~! th " V r-n h s U: D t) V x. ) la t q 0s s: 5' 5' 5] w' " smtev' y M m r z z J- ṉ 30 m TJ ya -4 S r ( - ~ ~ -. 0 7-4 5 a MHMIV HMM SB H BS KSBR HI s jsbb S S s % - m r f :"f 3Ff f -.-?? p. 'W l NV tj 3D ; S s -rn ss :~ ra c.-? r S w' 1 :X : V? r r s- 03 22 S 5-2 " r? t? 3 5- S? J S " S. s s -t X1"1!Jl ; l J S j" wrj l rn J -H <c/ P5l! 2?- T 2 \ t t. :. r\ -D 2?N 4s-s J A r a?5' 3 X"? JA l NT :. r- S- - c. A- - s r. \ X l V. ḵn " 0. x a J " s- -c r V fc r ~ A tk V t? ;U S; "- X X V,? S - r t f 5v v t f- V x K Requred te 3 6' 3 W w -n " t ut n y A z; y V ' n a J- -\ 3 - v w l! fc n m n> 73 m-n C r- r~ -c!" -4 I m n r~ r~ 1C Iz!z Tl nf v -4 16 r b t f n m ) x - x m f zz n m n x m?fc K; K v\ L f S rc fc f cjj n J. - K. -V S - ' - \1 - r- 2. S 2 XJ a 5. r- sj r? h 2-g ' -\ ', Q- \ L \ - 3 \ r x S 3.Q T 0 w c < 5 1". 4 l" l" b? ; l v;!-fc t r : 'A- : S V : H HM Mk\ 4l"l R. -V : r. c

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:,": ;' r -' v'vfl THE MIMING ACT R!:-'CRT F A t;)5tat Iplt s rlltnj l r r ch IJM; nf uvrk tu b c, f red..mnng Dvsn nme f Rrt. 'Jctr Hlder ' -, -., Mner's s Lcence...Jx. A Pst H;r.c Address /Iwtfut-, f Ij. perfrmnce f...jvt..'...,...,... dys f...jj./ c't lle fllwng cntguus clams type f wrk Dys,' Clam N. Days -., wnng Clam (s).y...,.,.,..,...,...,..,,.,..,... (In tht svf "gelgcal nd/r bphyscal survey (s) where mre than 18 clams r nvlved attach schedule) READ REFULLY: THE FL.'.WING INFRMATIN s REQUIRED BY THE MINJNG RECRDER.. bel Wrk, Strppng r penng up f Mnes, Snkng Shafts r ther Actual t f. n ng p r l n s - Names and )s f the men wh perfrmed the wrk nd the dates end hurs f ther emplyment. F 01 Damnd nd ther Cre Drllng - Ftage, N. and nc.11 f hles and dameter f cre. Nme nd dd'ecs f wne. peratr f drll. Dates when drllng was dne. Sgned cre lg nd ketch n duplcate. Fr CtMpressed Ar, r ther Pwer Drven r Meclnel Equprn;t Type f drll r equpment. Names nd addresses f men engage.d n peratng equpment and the dates nd hurs f ther rtvplymnt. FrxPwer Strppng - Type f equpment. Name nd address f wner r peratr. Amunt expended. Dates n whch was dn. Prf f actual cst must be submtted wthn 30 dys f recrdng. JVth each r the abve types f wrk sketches are requred t thw the lcatn nd extent f the wrk n relatn rmhe nearest clam pst. In the case f damnd r ther 1 cr drllng the sketch mutt b submtted n duplcate. fr Gelgcal nd Gephyscal Survey - The names nd addresses f men emplyed as well s dates. Typ f Urument used n the case f gephyscal survey. Reprts nd maps n duplcate must be fled wth the Mnster }4n 60 days f recrdng. \r.. J Land Survey - the name and address f ntar Land surveyr. The Retred Infrmatn Is s Fllws; (Attach a lst f lls space s r.suffce.!) y. x M U h- U Z ee tu u te Z ae pt-, l', ' 734, g q days /A? 4 04 /Z74&S, "c/-, j t "- 'Cc/? c/a/t/s 2UI cc w) w Dt Q..'' f t.' -tv.....- lfure f K : w r r Agnt M The Mnng Act Certfcate Verfyng Reprt f Wrk hereby certfy: v...,.../ -v /, {Ptr 'fc M H. f" " - : - - WTrW 1. Thf l have a persnal end Intmate kr.v '"T. " ''' t, havng perfrmed the wrk r v/twsqt.'rnnjfc.'. :':Vx f'kf ttf l tv "~ V L-' f" 2. That the annexed reprt tru. LJ t 'Ht' 11 the reprt f S. tu

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NTARI THE MINING ACT REPRT F WRK A rat frm U requred fer cck type f werk le k r crded. T the Recrder f... name f Recrded Hlder...7.6..WbjtRSX..rVfteJW Pst ffce Adrtress d hereby reprt the perfrmance f... days f nt befre reprted t be appled n the fllwng cntguus clams Clam N. 127480 127481 131728 " 131729 '"131730-1-31931-1-317.32 Days 1 1 18 r" 13 IB- l- Clam N. 131733 131734' Days 18 20 Clam N. Mner's Lcence type f wrk All,h. wrk wa, perfrmed n Mnng Clam (,)...S!!?? (In the case f gelgcal and/r gephyscal survey (s) where mre than 18 clams re nvlved attach a schedule) Days S ae a READ CAREFULLY: THE FLLWING INFRMATIN IS REQUIRED BY THE MINING RECRDER. Fr Manual Wrk, Strppng r penng up f Mnes, Snkng Shafts r ther Actual Mnng peratns - Names and addresses f the men wh perfrmed the wrk and the dates and hurs f ther emplyment. Fr Damnd and ther Cre Drllng - Ftage, N. and angle f hles and dameter f cre. Name and address f wner r peratr f drll. Dtes when drllng was dne. Sgned cre lg and sketch n duplcate. Fr Cmpressed Ar r ther Pwer Drven r Mechancal equpment Type f drll r equpment. Names and addresses f men engaged n peratng equpment and the dates and hurs f ther emplyment. Fr Pwe. Strppng - Type f equpment. Nme and address f wner r peratr. Amunt expended. Dates n whch wrk was dne. Prf f actual cst must be submtted wthn 30 days f recrdng. Wth each f the abve types f wrk sketches are requred t shw the lcatn and extent f the wrk n relatn t the nearest clam pst. In the cse f damnd r ther cre drllng the sketch must be submtted n duplcate. Fr Gephyscal, Gelgcal, Gecherncl Surveys nd Expendture Credts - the name f authr f reprt. Cverng dles f urvey (lnecutng 4 ffce). Type f nstrument used. Ttal amunt f expendture. Techncal reprts, mps,expendture breakdwn, recepts must be fled n duplcate wth the Mnster wthn 60 days f recrdng. Fr Land Survey - the name and addess f ntar Land surveyr. The Requred Infrmatn s s Fllws: (Attch lst f ths space s nsuffcent) (See attached sheets) 130 days manual labur perfrmed n clams f 127480, 127481, 131784 nclusve and be appled t clams 131728, 131729, 131730, 131731, 131732, 131733, 131734, 127480, 127481 nclusve Dte Sgnature / Recrded Hlder r AgeVt t t/ UI H U e u U e I u a. ae u l S UI U. l. Alan Barry 168 Mna st. The Mnng Act Certfcate Verfyng Reprt f Wrk (Pst ffce Address) DUPLICATE CP s PR QUALITY RIGIN,.Jj 1. That l have a persnal nd ntmate knwledge f the facts set frth n rdjqjfwjqve/0' t, havng perfrmed the. wrk r wtnessed same durng and/r after ts cmpletn. 2. That the annexed reprt s true. Dated. ct. 12/71.19 Sgnature

U.v NTAHI THE NING ACT REPRT F WRK A M't bm l rvlr4 fw veen tym ' wefc t k r eere'. T Hw Recrd f...,...m.h...,...,...,...,..,...,...mmng Dvsn,...;t?/; name f Recrdedlldr y, Mnr's Lcence.../.r, r ' PsfKe Address d hereby reprt the perfrmnce f.../.tt'.k'...,. dys f., nt befre reprted t be appled n the fllwng cntguus clams type f wrk lm N. Dys t Clam N. Dys ys j S.&2& M./ J.R.:, /Z.I.." s Clm N. Days.'J... 7? """ All the wrk was perfrmed n Mnng Clam (s). f.z.7..4.fc.u.a.2;fa..s...2v.jf.b'f.('.},',l'.f!k,...- (In th cs f gelgcal nd/r gephyscal survey (s) where mre than 18 clams re nvlved attach schedule) READ CAREFULL Y THE FLLWING INFRMATIN IS REQUIRED BY TH e MINING RECRDER. Fr Manual Wrk, Strppng r penng up f Mnes, Snkng Shafts r ther Actul Mnng pertns - Names and addresses f the men wh perfrmed the wrk and th dtes and hurs f thr emplyment. Fr Damnd nd ther Cre Drllng - Ftage, N. and angle f hles nd dameter f cre. Nme nd address f wner r peratr f drll. Dtes whn drllng was dne. Sgned cre lg nd sketch n duplcate. Fr Cmpressed Ar r ther Pwer Drven r Mechancal Equpment Type f drll r equpment. Names and addresses f men engaged n peratng equpment and the dtes nd hurs f ther emplyment. Fr Pwer Strppng - Type f equpment. Nme and address f wner r peratr. Amunt expended. Dales n whch wrk was dne. Prf f clul cst must be submtted wthn 30 days f recrdng. Wth each f the abve types f wrk sketches r requred t shw the lcatn and extent el the wrk n relatn t th nearest clam pst. In the cs f damnd r ther cre drllng the sketch must be submtted n duplcate. fr Gelgcal nd Gephyscal Survey - The names nd addresses f men emplyed as well s dates. Typ f nstrument used m th cs ' gephyscal survey. Reprts and mps n duplcate must be fled wth the Mnster wth. 60 days f recrdng. Fr Land Survey - the nme nd ddrss f ntn Lr.d surveyr. The Requred Infrmatn s s Fllws: (Attach lst f ths space s nsuffcent).".-t.,\--. -V t s ' 'H."'-. ' ' ')R Eels rv E M 2 DI...,U.U:/.!.. ecrded The Mnng Act Certfcate Verfyng Reprt f Wrk hereby certfy: (Pst ffce Address) ;;r.'j.v.".a:/t'..v..,..,as.7. '.f&z..q.... 1. That l have persnal 'and ntmt knwledge f th facts set frth n the reprt f wrk wumvd here t, havng perfrmed the wrk r wtnessed same durng nd/r after u cmputn. 2. That th annexed reprt s nu. ' w.d...jd#.:...y...9://..." ( '.....,...',/;./!. Sgnature T rv f l S

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NTARI THE MINING ACT REPRT F A efetete tem l reejlretl le eech type el wrk l be T the Recrder f...mnnj Dvsn l...?e.9.f.9s..a.?.f.hj??a.s.?..?~???.?.3 name f Recrded Hlder Mner's Lcence.Ayenue, Nrth..Bay,:.pntarp...".. d hereby reprt the perfrmance f...2.6.q... days f...f. nt befre reprted t be appled n the fllwng cntguus clams.,a.. type af wrk Clm N. 127480 '"127481 '"131728-1-31729 Dys l """ 36"" 37"" Clam N. UU.33. 131734 Days F 37 Clam N. Days 3-7...1-31331 3.7......131232 3.7... All the wrk ws perfrmed n Mnng Clam (s).j (n the case f gelgcal and/r gephyscal survey (s) where mre than 18 clams ara nvlved attach schedule) 9 READ CAREFULLY: THE FLLWING INFRMATIN IS REPUTED py THE UININC RECQgpgR. Fr Manual Wrk, Strppng r penng up f Mnes, Snkng Shafts r ther Actual Mnng peratns - Names and addresses f the men wh perfrmed the wrk and the dtes and hurs f ther emplyment. Fr Djamnd and ther Cre Drllng - Ftage, N. and angle f hles and dameter af care. Nme and address f wner r peratr f drll. Dtes when drllng ws dne. Sgned cre lg and sketch n duplcate. Fr Cmpessed Ar r ther Pwer Drven r Mechancal equpment Type f drll r equpment. Names and addresses f men engaged n peratng equpment and the dtes and hurs f ther emplyment. Fr Pwer Strppng - Type f equpment. Name and address f wner r peratr. Amunt expanded. Dtes n whch wrk ws dne. Prf f actual cst must be submtted wthn 30 days f recrdng. Wth each f the abve types f wrk sketches re requred t shw the lcatn and extent f the wrk n relatn t the nearest clam pst. In the case f damnd r ther cre drllng the sketch must be submtted n duplcate. Fr Gephyscl, Gelgcal, Gechemcl Surveys and Expendture Credts - the name f authr f reprt. Cverng dtes f survey (lnecuttng 8, ffce). Type f nstrument used. Ttal amunt f expendture. Techncal reprts, mps,expendture breakdwn, recepts mutt be fled n duplcate wth the Mnster wthn 60 days f recrdng. Fr Land Survey - the ncme and address f ntar Land surveyr. The Requred Infrmatn s as Fllws: (Attach lst f ths space s nsuffcent) (See attached lsts) 360 days plugger wrk perfrmed n clams l 127480, 127481, 131734, nclusve and t be appled t cntguus clams ft 131728, 131729, 131730, 131731, 131732, 131733, 131734, 12780 and 12781 nclusve Dte ct. 12/71 Sgnture f RcrVlaV Agent The Mnng Act Certfcate Verfyng Reprt f Wrk..A.a.n..?.a.?.:f.y... 168 Mna St. Chelmsfrd, ntar,...y.. hereby certfy: 1. Tht l hve persnal and ntmate knwledge f the facts set frth n the reprt t, havng perfrmed the. wrk r wtnessed sme durng and/r after ts cmpletn. 2. That the annexed reprt s true. Dt.d,,.9.St...r?77,..19 ure

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