SILVERPOINT DDS: Drilling Activity Notification Date Submitter's Reference Contact information Licence company Name CONTACT NAMETelephoneEmail ENVIRONMENTAL CONTRACTOR company Name CONTACT NAMETelephoneEmail SUBMISSION INFORMATION Well License Number Unique Well Identifier Surface Location Remote site used for drilling waste management?YesNo LSD Sec Twp Rge Mer wASTE STREAM Well Section well section well section 1 well section 2 well section 3 well section 4 well section 5 Drilling fluid/waste stream type Drilling fluid/waste stream type Drilling fluid/waste stream type 1 Drilling fluid/waste stream type 2 Drilling fluid/waste stream type 3 Drilling fluid/waste stream type 4 Drilling fluid/waste stream type 5 Disposal option Disposal option Disposal option 1 Disposal option 2 Disposal option 3 Disposal option 4 Disposal option 5 Offsite Disposal Offsite Disposal Offsite Disposal 1 Offsite Disposal 2 Offsite Disposal 3 Offsite Disposal 4 Offsite Disposal 5 Disposal Location Disposal Location Disposal Location 1 Disposal Location 2 Disposal Location 3 Disposal Location 4 Disposal Location 5 Facility Name Facility Name Facility Name 1 Facility Name 2 Facility Name 3 Facility Name 4 Facility Name 5 Facility ID # Facility ID # Facility ID # 1 Facility ID # 2 Facility ID # 3 Facility ID # 4 Facility ID # 5 DESCRIPTION OF MUD SYSTEM Surface Description TOP/INTERMEDIATE MAINHOLE DESCRIPTION DESCRIPTION DESCRIPTION CEMENT RETURNS DESCRIPTION ADDITIONAL INFORMATION COMMENTS