| perpetuated and fixed. | | _____________________________________|_____________________________________ Date | Authorized Signature | | | ________________|__________________________________________________________ (_See reverse_) APPENDIX #6 ------------------------------------------------------------------------ [Illustration: APPENDIX #7] Form 3400–5 UNITED STATES | Place (December 1966) DEPARTMENT OF THE INTERIOR |_____________________________ (formerly 4–286a) BUREAU OF LAND MANAGEMENT | | Date |_____________________________ | | INSTRUCTIONS | | The Director, Bureau of Land | Management, and the manager APPROVAL OF MINERAL SURVEY | of the appropriate land (or | land and survey) office must | be notified of the approval | of each mineral survey, | using this form. _____________________________________________|_____________________________ _____________________________________ _____________________________________ SIR: