42F84NW8183 11 MAPLEDORAM010

DIAMOND DRILLING

TOWNSHIP: MAPLEDORAM REPORT NO: 11

WORK PERFORMED FOR: GRANGES INC.

RECORDED HOLDER: SAME AS ABOVE [x]

OTHER

CLAIM NO. HOLE NO. FOOTAGE DATE NOTE

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Ministry ofNorthern Developmentand Mines

Ontario

DOCUMENT No.

W9140Inatructlnn*

42F04NWB183 11 MAPLEDORAM 900

Mining Act Report of Workharris and Address of Recorded Holder Prospector's Licence No.

T- f*7*Telephone No.

' \ 3mmary of Distribution of Credits and Work Performance

/Ijninfl Division /~. \ lA^'Jv'uA.t;''^" \jCL^s^\

Township or Area

rotal Assessment Credits Claimed

^2^^~^(^2- ^^"ype of Work Performed Check one only)

J Manual Work—, Shaft Sinking Drifting or other J Lateral Work

J Mechanical equipment

— j Power Stripping other than Manual , ̂ . 1 (maximum credit allowed - 100 days

per claim) [^Diamond or other Core drilling

]Core Specimens

Mining ClaimPrefix

TP.1 fXv

UsTP.

Number

1 \2u32'5KZ^'3/2|iZfe?3361(2C'3K\U 2^ 3^.?

Work Days Cr.

*5b

60^O^0

*P6

Mining ClaimPrefix

'

NumberWork

Days Cr.M

Prefixning Claim

NumberWork

Days Cr.

•ates when work was performed

•rom: ^tv^ "^ l /q \ | To: J± Total No. of Days Performed Total No. of Days Claimed, Total No. of Days to be Claimed at a Future Date /\ ^

II the work was performed on Mining Claim(s): •dicate no. of days performed on each claim. (See note No. 1 on reverse side)ing Claim No of Days Mining Claim No. of Days

Mining Claim

B U2JU325Mining Claim

No. of Days

^#No. of Days

Mining Claim

Mining Claim

No. of Days

No. of Days

Mining Claim

Mining Claim

No. of Days

No. of Days

Mining Claim

Mining Claim

No. of Days

No. of Days

iequired Information eg. type of equipment, Names, Addresses, etc. (See Table on reverse side) f space below is insufficient, attach schedules with required information and location sketches

ONTARIO GEOLOGICALGIS- ASSESSMENT FILES

MAY 2 7 1991

crs

roen

-o

r-oCO

rtification of Beneficial Interest * (See Note No. 2 on reverse side)hereby certify that, at the time the work was performed, the claims covered in this report

. work were recorded in the current recorded holder's name or held under a beneficial interest y the current recorded holder.

Date ,"yfcT" i f 1 ^- ' l M,

i , 1

Recorded (Signature)

rtification Verifying Report of Workhereby certify that l have a personal and intimate knowledge of the facts set forth in the Report of Work annexed hereto, having performed the work - witnessed same during and/or after its completion and the annexed report is true. *

me and Address of Person Certifyi

Office Use Onlyrk Assignments

7 x s/2 C? 32 3 75Received Stamp

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