MTA Approved Form 20 Mineral Titles Act Section 93(3) Regulation 98 – COMPANY DETAILS: Operating Company: Date: Postal Address: Contact Name: Phone No: Email: DRILLING DETAILS: (Please complete one form for each hole drilled) Drill Hole Name/No.: GDA94 UTM Coordinates: Locality/Prospect Name: m EAST Depth of Hole (m): m NORTH Drilling Completion Date: Zone: Source of Coordinates: (eg. Hand held Title Type/No.: GPS) Geological Province: 1:250K Map Sheet Name: Azimuth: 1:100K Map Sheet Name: Declination: Does core contain radioactive minerals? Core to bedding angle: Radiation level above background µSv/hr SAMPLES TO BE SUBMITTED: Core Intervals: Core Diameter: No. of Core Trays: No. of Pallets: No. of Cutting Samples: Comments (e.g. 5 trays missing, trays 1-3 damaged) Cutting Intervals: Note: Form to be submitted to Core Facility Manager with sample. Refer to Geological Sample Submission (Core and Cuttings) procedure. Department of Primary Industry and Resources use only Report No.: Rack Location: Recorded by: Date Recorded:
MTA Approved Form 20 Mineral Titles Act – Section 93(3) Regulation 98 COMPANY DETAILS: Operating Company: Date: Postal Address: Contact Name: Phone No: Email: DRILLING DETAILS: (Please complete one form for each hole drilled) Drill Hole Name/No.: GDA94 UTM Coordinates: Locality/Prospect Name: m EAST Depth of Hole (m): m NORTH Drilling Completion Date: Zone: Title Type/No.: Source of Coordinates: (eg. Hand held GPS) Geological Province: 1:250K Map Sheet Name: Azimuth: 1:100K Map Sheet Name: Declination: Does core contain radioactive minerals? Core to bedding angle: Radiation level above background µSv/hr SAMPLES TO BE SUBMITTED: Core Intervals: Core Diameter: No. of Core Trays: No. of Pallets: No. of Cutting Samples: Comments (e.g. 5 trays missing, trays 1-3 damaged) Cutting Intervals: Note: Form to be submitted to Core Facility Manager with sample. Refer to Geological Sample Submission (Core and Cuttings) procedure. Department of Primary Industry and Resources use only Report No.: Rack Location: Recorded by: Date Recorded:
geological-sample-submission-form.docx