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C: LANDS BRANCH O

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Ministry ofNorthern Developmentand Mines

Ontario

Report of Work Conducted After Recording Claim

Mining Act

i Transaction Number

. ooo7oPersonal information collected on this form is obtained under the authority ol the Mining Act This information will be used for correspondence. Questions about this collection should be directed to the Provincial Manager Mining Lands, Ministry of Northern Development and Mines, Fourth Floor 159 Cedar Street Sudbury, Ontario, P3E 6A5, telephone (705) 670-7264

Instructions: - Please type or print and submit in duplicate.- Refer to the Mining Act and Re

Recorder.- A separate copy of this form m- Technical reports and maps mi- A sketch, showing the claims t 52jo2SEooo82.i68oi SQUAW LAKE

2.1680 l' the Mining

900

Recorded Holder(s)

K E Aj Client No

Aoaress

/ 72i Telephone No

nirm

FATTownship/Area

5 (a1 u/J ii y l-1-) rt E'M or G Plan No

Dates Work Performed

From:: 5^-Pr 3 o To:

Work Performed (Check One Work Group Only)Work Group Type

Geotechnical Survey

Physical Work, : Including Drilling P ft L, ^ r re j i /v c -y- He vp sr/? i P

Rehabilitation

Other Authorized : Work

Assays

Assignment from Reserve

Total Assessment Work Claimed on the Attached Statement of Costs S

Note: The Minister may reject for assessment work credit all or part of the assessment work submitted if the recorded holder cannot verify expenditures claimed in the statement of costs within 30 days of a request for verification.

Persons and Survey Company Who Performed the Work (Give Name and Address of Author of Report)Name

FD ft'&c/ltfK'i

'

(attach a schedule if necessary)

Certification of Beneficial Interest * See f*

Address

So *~ y 7 -z RIUE& Ten. /Tiftn//l^/ w * j * ^^-^ * J * *^ 4—-. * * ' ** '

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RECEIVED

|. OCT 101996

MINING UNDS BRANCH

j l certify that at the time the work was performed, the claims covered in this work report were recorded in the current holder's name or held under a beneficial interest

1 by the current recorded holder.

Date

5 f P T J?c

Recorded Holder or Agent (Signature) ;

Q/y^/ ^

Certification of Work Report

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Value of Assessmei Work Don on this Clai

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Credits you are claiming in this report may be cut back. In order to minimize the adverse effects of such deletions, please indicate from which claims you wish to priorize the deletion of credits. Please mark (^) one of the following:

1. CH Credits are to be cut back starting with the claim listed last, working backwards.2. eH Credits are to be cut back equally over all claims contained in this report of work.3. ^credits are to be cut back as priorized on the attached appendix. C-? l

In the event that you have not specified your choice of priority, option one will be implemented.

Note 1: Examples of beneficial interest are unrecorded transfers, option agreements, memorandum of agreements, etc., with respect to the mining claims.

Note 2: If work has been performed on patented or leased land, please complete the following:

r l certify that the recorded holder had a beneficial interest in the patented or leased land at the time the work was performed.

S 9nature Date

Jntano

Ministry ofNorthern Developmentana Mines

Mmistere du Deveioppement au Nord et aes mines

Statement of Costs for Assessment Credit

Etat des couts aux fins du credit devaluation

Mining Act/Loi sur les mines

Transaction No./N" de transaction

W9fa3o. OOP 7o

2. l 68 O fPersonal information collected on this form is obtained under the authority of the Mining Act This information will De used to maintain a record and ongoing status of the mining claim(s). Questions about this collection should De directed to the Provincial Manager, Minings Lands, Ministry of Northern Development and Mines, 4th Floor. 159 Cedar Street, Sudbury, Ontario P3E 6A5. telephone (705) 670-7264

Les renseignements personnels contenus dans la presente formule soni recueillis en vertu de la Loi sur les mines et serviront a (emr a jour un registre des concessions mimeres. Adresser toute quesiton sur la collece de ces renseignements au chef provincial des terrains mmiers. ministere du Deveioppement du Nord et des Mines, 159, rue Cedar. 4e etage. Sudbury (Ontario) P3E 6A5, telephone (705) 670-7264

1 . Direct Costs/Couts directs

Type Description

Wage* i Labour V ^A ** *,a Salaires i Main-d'oeuvre

Field Supervision Supervision sur le terrain

Contractor's ype and Consultant'sFees Oroits de l 'entrepreneur

Amount Totals Montan! Total global

(o 03

et de I'expert- conseil

Supplies Used Type i Fournitures

utilisees

Equipment ylj- i f J ~ Rental b * ''-* * ~"y -v ' yjoLocation de materiel

Total Direct Costs Total des couts directs

600

/3o

73 o

2. Indirect Costs/Couts indirectsNote: When claiming Rehabilitation work 1

allowable as assessment work Pour le remboursement des travauxcouts indirects ne sont pas admissible devaluation

Type

Transportation i Transport

i

i

i i

i i

Food and Lodging

i Nourriture et hebergementMobilization and Demobilization Mobilisation et demobilisation

Description

Type M L -/V k '-..*-

&J

idirect costs are not

de rehabilitation, les s en (ant que travaux

Amount i Totals Montan! j Total global

jjVo

/oo

Sub Total of Indirect Costs Total partiel des couts indirects

Amount Allowable (not greater than 20*b of Direct Costs) Montant admissible (n'excedant pas 20 H des couts directs)Total Value of Asse (Total of Direct and A indirect costs)

ssment Credit Valeur totale du credit llowable d'evaluation

(Total des couts directs et indirects admissible*

3oo

/CO

4oo1^tl(*

Note: The recorded holder will be required lo verify expenditures claimed in this statement of costs within 30 days of a request for verification. If verification is not made, the Minister may reject for assessment work all or pan of the assessment work submitted

Filing Discounts

1 ) Work filed within two years of completion is claimed at 100QXo of the above Total Value of Assessment Credit.

Note : Le titulaire le present effet. Si \ a ou une pi

Remises pour

enreqistre sera tend de verifier les de

rtie des travaux d'evaluation prese

UU l 1 0 1996depot MINING LANDS BRANCH

penses demandees dansmt une demande k c et nistre peut rejeter tout iles

rembourses a 100 "/o de la valeur totale susmentionnee du credit d'evaluation.

2 Work filed three, four or five years after completion is claimed at 500xo of the above Total Value of Assessment Credit. See calculations below:

Total Value of Assessment Credit Total Assessment Claimed

x 0.50

2 Les travaux deposes trois, quatre ou cinq ans apres leur achevement sont rembourses d 50 "/o d e la valeur totale du credit d'evaluation susmentionne Voir les calculs ci-dessous.

Valeur totale du credit d'evaluation

x 0,50Evaluation totale demandee

Certification Verifying Statement of Costs

l hereby certify:that the amounts shown are as accurate as possible and these costs were incurred while conducting assessment work on the lands shown on the accojmpanying Report of Work form.

that as INC(Recorded Holder. Agenl. Position in Company)

to make this certification

Attestation de I'etat des couts

J'atteste par la presente :que les montants indiques sont le plus exact possible et que ces depenses ont ete engagees pour effectuer les travaux d'evaluation sur les terrains indiques dans la formule de rapport de travail ci-joint.

Et qu'a litre de. je suis autonse(titulaire enregistre, represents , posle occupe dans la compagmej

faire cette attestation.

Signature. i Date

O?i? 104/91 Nota Dans cette lormule. lorsqu'il designs des personnes le masculm est ulihseau sens neutre

o .a

50 000'—'

1 611965 i

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90 0 45' 44

Bob K

RECEIVED

OCT l o 1996

MINING LANDSBBAwru

42'

Ministry ofNorthern Developmentand Mines

November 25, 1996

Sharon Kemash Mining Recorder Queen and Fourth P.O. Box 3000 Sioux Lookout, ON P8T 1C6

Ministere du Developpement du Nord et des Mines Ontario

Geoscience Assessment Office 933 Ramsey Lake Road 6th Floor Sudbury, Ontario P3E 6B5

Telephone: Fax:

(705) 670-5853 (705) 670-5863

Dear Sir or Madam: Submission Number: 2.16801

Subject: Transaction Number(s): W9630.00070

After reviewing the Work Report(s) we have prepared this letter and the attached summary, which lists the results of our review. Requirements of the Assessment Work Regulation may not have been fully met. Please examine the summary to determine the next course of action concerning the identified Work Report(s).

NOTE: The 90 day deemed approval provision, subsection 6(7) of the Assessment Work Regulation, is no longer in effect for this submission.

PLEASE NOTE ANY REQUESTED REVISIONS MUST BE SUBMITTED IN DUPLICATE.

If the anniversary dates for the mining claims affected by this correspondence have not passed, a number of options are available. Please contact the Mining Recorder to discuss these options.

If you have any questions regarding this correspondence, please contact Bruce Gates at (705)670-5856.

Yours sincerely,

ORIGINAL SIGNED BYRon C. GashinskiSenior Manager, Mining Lands SectionMines and Minerals Division

Correspondence ID: 10380 Copy for: Assessment Library

Work Report Assessment Results

Submission Number: 2 .16801

Date Correspondence Sent: November 25, 1996 Assessor: Bruce Gates

Transaction Number

First Claim Number

W9630.00070 612056

Section:10 Physical PSTRIP 9 Prospecting PROSP

Township(s) l A rea(s)

SQUAW LAKE

Status

Approval After Notice

Approval Date

November 21, 1996

Correspondence to:Mining Recorder Sioux Lookout, ON

Resident Geologist Sioux Lookout, ON

Assessment Files Library Sudbury, ON

Recorded Holder(s) and/or Agent(s):EDWARD ARTHUR ROBERECKI RIVERTON, MANITOBA

Page: l

Correspondence ID: 10380

Beckington Lake Area G-253 290945'

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OCT l O 1996

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l90045'44' 43' 42'

41 40' 39'38 37' 36' 35' 34' 33' 32

31'90030'

Quest Loke Area-G-255656)903

LEGEND

PATENTED LANDCROWN LAND SALELEASESLOCATED LANDLICENSE OF OCCUPATIONMINING RIGHTS ONLYSURFACE RIGHTS ONLYROADSIMPROVED ROADSKING'S HIGHWAYSRAILWAYSPOWER LINESMARSH OR MUSKEGMINESCANCELLED c.

REFERENCES

AR E AS WITH D R AWN F ROM DISPOSITION

M.H.O. -MINING R.CHTSOMLY

S.R.O. - SURFACE RIGHTS ONLY

M.+ S. - MINING AND SURFACE RIGHTS

Description Order No. Date D isposition

Z

— J File CO

O

AREA

SQUAW LAKEM.N.R. ADMINISTRATIVE DISTRICT

DRYDENMINING JiVIStQN

PATRICIALAND TITLES/ RF JIS'RY DIVISION

THUNDER BAYMinistryof LandNatural Management

Resources BranchOntario

FEBRUARY , 1984 fi a m it e:

G-3140

m o O3D O m

52J02SE0008 2.16801 SQUAW LAKE 200

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